Table 1.
Model | Base Case Value | Source |
---|---|---|
Distribution of patients according to risk group | ||
Low risk | 52.7% | Humana |
Intermediate risk | 34.6% | Humana |
High risk | 12.7% | Humana |
Relative reduction in risk with chemotherapy | ||
Patients at low risk | 131.0% | Paik et al10 |
Patients at intermediate risk | 61.0% | Paik et al10 |
Patients at high risk | 26.0% | Paik et al10 |
Resource costs | ||
Chemotherapy | $7,026 | Humana |
Supportive care | $9,606 | Humana |
Adverse events | $1,761 | Humana |
Recurrence | $104,000 | Oratz et al11 |
Utility of health states | ||
QALY loss associated with chemotherapy | 0.5 | Muss et al,12 Simes et al13 |
QALY loss associated with recurrence | 9.1 | Muss et al,12 Piccart et al,14 Ravdin et al,15 Simes et al13 |
QALY loss associated with second primary cancer caused by chemotherapy | 9.0 | Muss et al,12 Piccart et al,14 Ravdin et al,15 Simes et al13 |
Chemotherapy recommendation before RS | ||
Before RS low risk | 50% | Meta-analysis |
Before RS intermediate risk | 55% | Meta-analysis |
Before RS high risk | 60% | Meta-analysis |
Other parameters | ||
Mean age, years | 59 | Humana |
Discount rate | 3% | Weinstein et al16 |
Time horizon | 40 | Lifetime horizon |
NOTE. See Appendix Table A2 for distributions used for sensitivity analyses.
Abbreviations: QALY, quality-adjusted life-year; RS, recurrence score.