|Summary of important one-and two way sensitivity analysesa|
|Interpretation of the incremental impact of the RS-assay compared to CCP|
|Variable (range tested)||Negative cost and effect||Cost saving||ICER in the range||ICER in the range||ICER in the range||Dominated|
|0 to 20,000 $/QALY gained||20,000 to 100,000 $/QALY gained||>100,000 $/QALY gained|
|Chemotherapy treated women in intermediate risk group by the RS-assay (0% to 100%)||0% to 42%||43% to 63%||64% to 100%|
|Change in absolute risk of relapseb in the RS-assay model (−10% to +10%)||> +1.8%||≤ +1.8%|
|Change in utility of recurrencec (−10% to +10%)||Lower limit cost of recurrencec||≤ +2.2%||+2.3% to +3.4%||+3.5% to +4%||≥ +4%|
|Baseline cost of recurrencec||> +3%||≤ +3%|
|Upper limit cost of recurrencec||> +3%||≤ +3%|
|Change in utility following adjuvant chemotherapy (−10% to +10%)||> +1%||≤ +1%|
CMF = 6 cycles of cyclophosphamide, methotrexate, 5-fluorouracil; AC = 4 cycles of adriamycin, cyclophosphamide; CCP = current clinical practice.
a Values in the table show how the incremental impact of the RS-assay compared to CCP changes, over 6 significant ranges, depending on the values of certain key parameters. For example, if between 43-63% of women identified as intermediate risk by the RS-assay were to receive chemotherapy, then the RS-assay would be cost saving relative to CCP; if this proportion is 64% or greater, then the RS-assay has an ICER between 0 and $20,000 / QALY gained.
b Relapse includes loco-regional recurrence, distant recurrence and death due to any cause.
c Recurrence includes loco-regional and distant recurrences.
Hannouf et al.
Hannouf et al. BMC Cancer 2012 12:447 doi:10.1186/1471-2407-12-447