Money down.

Oncotype DX (ODX) scores have changed the paradigm of systemic therapy for ER(+) breast cancer, with the obvious advantage of helping pick out women who can safely skip the cytotoxic stuff. But how cost-effective is this test, really, when performed on everyone? Considering average cost of the test itself is $3217. This SEER analysis of over 30K Medicare beneficiaries ages 66-75 with localized ER(+) breast cancer aims to detect the impact of ODX score on management and medical costs. Overall, 18% of these women had an ODX score, and alas those getting an ODX had slightly higher medical costs. Not surprisingly, the 75% with clinically low to intermediate risk disease (i.e., T1-3 and N0) were more likely to get chemo with ODX while the 25% with clinically high risk disease were less likely. Given that receipt of chemo more than doubles overall healthcare expenditures associated with a breast cancer diagnosis, the cost analysis followed suit. TBL: When it comes to population costs, Oncotype DX scores only save money among women who would otherwise default receive chemo. | Dinan, J Natl Compr Canc Netw 2019