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Genomic Testing Linked to Lower Healthcare Costs in High-Risk Breast Cancer Patients


Recurrence score testing was associated with lower costs among high-risk cancer patients.


Researchers at Duke University found that genomic recurrence score testing using the 21-gene assay was linked with decreased cancer costs among certain patients with breast cancer who would otherwise receive standard chemotherapy.

The study, published in the March issue of JNCCN-Journal of the National Comprehensive Cancer Network, found that recurrence score testing was associated with lower costs among patients with high-risk disease in terms of relative costs and absolute costs ($6,606). Chemotherapy costs were also lower for this subset of patients ($3,622) and noncancer costs were slightly lower ($2,353).

Recurrence score testing was associated with higher overall costs in intermediate-risk and low-risk patients, due to higher noncancer costs. There were no differences in mean chemotherapy costs.

“This study demonstrates that (recurrence score) testing provides the greatest reduction in costs among patients who, prior to the test, had the highest likelihood of receiving chemotherapy to begin with,” said Michaela A. Dinan, Ph.D., Duke Clinical Research Institute.

The researchers gathered data from a Surveillance, Epidemiology and End Results and Medicare linked data set of more than 30,000 Medicare beneficiaries between 66 and 75-years-old that were diagnosed with ER-positive, non-metastatic, invasive breast cancer between 2005 and 2011. Costs were calculated by summing Medicare payments from patient claims.

Almost 18 percent of the patients received recurrence score testing as part of their initial workup, with 13.3 percent clinically classified as low-risk, 69.5 percent as intermediate-risk and 17.2 percent as high-risk.

Patients in the high-risk group were more likely to be younger, have comorbid conditions, live in census tracts with lower socioeconomic status and receive chemotherapy.

Only 9.3 percent of the high-risk group underwent recurrence score testing. Patients with high-risk disease were less likely to receive chemotherapy if they had recurrence score testing.

“Our research indicates that selective use of (recurrence score) testing, particularly for people with clinically-determined high-risk, non-metastatic breast cancer, provides treatment benefit and cost savings,” Dinan said.

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