Cost effectiveness of using prognostic information to select women with breast cancer for adjuvant systemic therapy of breast cancer
Doug Altman with Chris Williams, Susan Brunskill, Mark Lodge, Helen Campbell, Andrew Briggs, Kathy Johnston, Alastair Gray, Adrian Harris, Mike Clarke (Oxford)
The principal objective of this project was to investigate the cost-effectiveness of using prognostic information to identify patients who should receive adjuvant therapy by developing a decision analytic model to estimate an incremental cost per life year gained and per quality life year gained for prognostic groups. This objective was met by:
1. Identifying prognostic models that reliably distinguish clinically important variation in prognosis among groups of women with newly diagnosed breast cancer;
2. Identifying predictive factors that reliably predict clinically important variation in response [overall survival, disease free survival, mortality] to adjuvant therapy among groups of breast cancer patients;
3. Surveying the current use of prognostic information and use of adjuvant therapy in the UK;
4. Developing a decision analytic model to integrate the above information with data on costs and quality of life, in order to estimate incremental cost per life year or per quality adjusted life year gained.
To help to achieve the aims, several systematic reviews of the literature are being carried focussing on: prognostic models in breast cancer; predictive factors in breast cancer (single studies and review articles); reviews of prognostic information in breast cancer (review articles); the clinical use of prognostic information in breast and other cancers; and quality of life, cost and cost effectiveness studies relevant to modeling cost-effectiveness of adjuvant systemic therapy for breast cancer.
