Receipt of the 21-gene recurrence score assay (RS) impacts breast cancer treatment and health care costs, but that impact varies between women younger than 55 years and women 75 years and older, a study published online ahead of print in the Journal of Clinical Oncology has shown.1
Merging data from the Pennsylvania Cancer Registry on women with early stage breast cancer from 2007 to 2010 with administrative claims from the 12-month periods before and after their diagnoses, these researchers sought to determine the impact of RS receipt on subsequent chemotherapy use and medical expenditures among patients with early stage breast cancer. Propensity score-weighted regression models were estimated to identify the effects of RS receipt on chemotherapy use and medical spending in the year after diagnosis.
Among women younger than 55 years, chemotherapy use was 19.2% lower (95% CI, 10.6 to 27.9) and adjusted 1-year medical spending was $15 333 lower (95% CI, $2841 to $27 824). However, both chemotherapy use and medical spending were higher (5.7%; 95% CI, 0.4 to 11.0 and $3489; 95% CI, $857 to $6122, respectively) among women 75 to 84 years old.
The study findings show that the impact of RS receipt on chemotherapy use and health care costs varied markedly by patient age. Adjuvant chemotherapy use was reduced and health care spending was lower among women younger than 55 years. Among women 75 to 84 years old, chemotherapy use was increased and spending was slightly higher.
The researchers conclude, “From a population perspective, the impact of RS testing on breast cancer treatment and health care costs is much greater in younger women.”
1. Epstein AJ, Wong YN, Mitra N, et al. Adjuvant chemotherapy use and health care costs after introduction of genomic testing in breast cancer [published online ahead of print November 23, 2015]. J Clin Oncol. doi:10.1200/JCO.2015.61.9023.