Table 1. Input parameters for the Budget Impact Analysis model.
| Parameter | Values | Source | |||||||||||
| Patient population | |||||||||||||
| Breast cancer incidence in the Netherlands: | |||||||||||||
| 2017 2018 2019 2020 2021 2022 |
17207 17308 17409 17510 17611 17712 |
Dutch registries [24,25] |
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|
Percentage of these BC patients: |
|||||||||||||
| that receives localization (%) | 31.8% | [20] | |||||||||||
| that receives neo-adjuvant chemotherapy (%) annual increase of % receiving NACT # Hospitals that provide BC care in 2017 |
19% 1.3% 105 |
[26] Based on historic trends [20,26] [27] |
|||||||||||
|
Future utilization of localization techniques in Dutch patients Standard of care scenario (without MSL) • Assumption: All hospitals that would adopt MSL, adopt RSL before 2022 • Assumption: All hospitals have a similar share in BC patients to calculate the number of hospitals per technique • Assumption: A new localization technology has a redemption period of 5 years (implementation costs) | |||||||||||||
|
localization technique used in % patients per year (# of hospitals that use a certain technology) |
|||||||||||||
| WGL | RSL | MSL | |||||||||||
| 2017 | 79% (83) | 21% (22) | 0% (0) | [20] | |||||||||
| 2018 | 71% (74) | 29% (31) | 0% (0) | Adoption curve of Rogers | |||||||||
| 2019 | 60% (63) | 40% (42) | 0% (0) | Adoption curve of Rogers | |||||||||
| 2020 | 52% (55) | 48% (50) | 0% (0) | Adoption curve of Rogers | |||||||||
| 2021 | 40% (42) | 60% (63) | 0% (0) | Adoption curve of Rogers | |||||||||
| 2022 | 30% (31) | 70% (74) | 0% (0) | Assumption | |||||||||
|
Standard of care with the introduction of MSL • Assumption: Adoption follows the adoption curve of Rogers [28] • Assumption: All hospitals have a similar share in BC patients to calculate the number of hospitals per technology • Assumption: A new localization technique has a redemption period of 5 years (implementation costs) | |||||||||||||
|
localization technique used in % patients per year (# of hospitals that use a certain technology) |
|||||||||||||
| WGL | RSL | MSL | |||||||||||
| 2017 | 79% (83) | 21% (22) | 0% (0) | [20] | |||||||||
| 2018 | 76% (80) | 24% (25) | 0% (0) | Adoption curve of Rogers | |||||||||
| 2019 | 72% (76) | 27% (28) | 1% (1) | Adoption curve of Rogers | |||||||||
| 2020 | 65% (68) | 32% (34) | 3% (3) | Adoption curve of Rogers | |||||||||
| 2021 | 53% (56) | 36% (38) | 11% (11) | Adoption curve of Rogers | |||||||||
| 2022 | 30% (31) | 40% (42) | 30% (32) | Expert opinion NKI-AvL | |||||||||
| Intervention costs | |||||||||||||
| WGL | € 2 617 | ||||||||||||
| Personnel costs | €279 | (11%) | [29,30] | ||||||||||
| Material costs | €43 | (2%) | Hospital specific purchase costs (interviews) | ||||||||||
| Intervention costs (surgery and imaging) | €2 173 | (83%) | [31] and NKI-AvL | ||||||||||
| Equipment costs | - | (0%) | |||||||||||
| Overhead | € 123 | (5%) | [30] | ||||||||||
| RSL | € 2 834 | ||||||||||||
| Personnel costs | €321 | (11%) | [29,30] | ||||||||||
| Material costs | €118 | (4%) | Hospital specific purchase costs (interviews) | ||||||||||
| Intervention costs (surgery and imaging) | €2 173 | (77%) | [31] and NKI-AvL | ||||||||||
| Equipment costs | €53 | (2%) | Hospital specific purchase costs (interviews) | ||||||||||
| Overhead | €168 | (6%) | [30] | ||||||||||
| MSL | € 2 662 | without the costs of the magnetic seed | |||||||||||
| Personnel costs | €279 | (9%) | [29,30] | ||||||||||
| Material costs | €12 | (17%) | Hospital specific purchase costs (interviews) | ||||||||||
| Intervention costs (surgery and imaging) | €2 173 | (73%) | [31] and NKI-AvL | ||||||||||
| Equipment costs | €49 | (2%) | Hospital specific purchase costs (interviews) | ||||||||||
| Overhead | €149 | (5%) | [30] | ||||||||||
| Costs of the magnetic seed | + | €100 – €500 | Assumption | ||||||||||
| Additional costs for patients receiving neoadjuvant chemotherapy | |||||||||||||
| Using WGL (material and overhead) |
€146 | Hospital specific purchase costs (interviews); [30] | |||||||||||
| Using MSL (material and overhead) |
€146 | ||||||||||||
| Average inflation ratio to account for an increase in costs in the future | 1.0116 | Assumption based on Dutch inflation rates of the past 5 years [32] | |||||||||||
| Implementation costs | |||||||||||||
| WGL | N.A. | ||||||||||||
| RSL (yearly costs) | € 26 826 (€5.553) | Based on costs of 2017 [29,30] and NKI-AvL Process analysis by interviews in 5 hospitals. On average 332.75 hours of work |
|||||||||||
| Personnel | €18 629 | ||||||||||||
|
Overhead |
€8 197 |
||||||||||||
| MSL (yearly costs) | € 2 794 (€578) | Based on costs of 2017 [29,30] and NKI-AvL Process estimation based on interviews in the NKI-AvL estimated hours of work: 24 for training and writing protocols | |||||||||||
| Personnel | €1 940 | ||||||||||||
| Overhead | €854 | ||||||||||||
Abbreviations: WGL: Wire-guided Localization, MSL: Magnetic Seed Localization, RSL: Radio-active Seed Localization, BC: Breast Cancer S2 Appendix and C contain specific details on the cost components incorporated in the intervention costs (including actual costs) presented here.