Clinical data
|
Monitoring performanceb (proportions)
|
True favourable
|
0,53
|
0,04
|
0,53/0,04
|
Dirichlet
|
[10]
|
True unfavourable
|
0,24
|
0,05
|
0,24/0,05
|
Dirichlet
|
[10]
|
False favourable
|
0,17
|
0,07
|
0,17/0,07
|
Dirichlet
|
[10]
|
False unfavourable
|
0,07
|
0,09
|
0,07/0,09
|
Dirichlet
|
[10]
|
Chemotherapy related toxicities
|
Vomiting
|
3×AC
|
0,05
|
0,02
|
5/98
|
beta
|
[24]
|
3×DC
|
0,24
|
0,04
|
24/77
|
beta
|
[24]
|
HFS
|
3×DC
|
0,22
|
0,04
|
23/80
|
beta
|
[24]
|
Neutropenia
|
3×AC
|
0,85
|
0,04
|
86/15
|
beta
|
[24]
|
3×DC
|
0,72
|
0,04
|
74/29
|
beta
|
[24]
|
Desquamation
|
3×DC
|
0,05
|
0,02
|
5/98
|
beta
|
[24]
|
CHF
|
3×AC
|
0,002
|
0,20
|
1/359
|
beta
|
[23]
|
6×AC
|
0,02
|
0,60
|
11/349
|
beta
|
[23]
|
AML/MDS
|
3×AC
|
0,003
|
0,001
|
12/4471
|
beta
|
[25]
|
6×AC
|
0,005
|
0,001
|
12/2372
|
beta
|
[25]
|
Transition probabilities
|
Relapse
|
RG-NACT; False favourable/unfavourable
|
Tp1
|
0,14
|
0,06
|
4/24
|
beta
|
[10]
|
Tp2
|
0,29
|
0,08
|
8/20
|
beta
|
[10]
|
Tp3
|
0,47
|
0,09
|
13/15
|
beta
|
[10]
|
Tp4
|
0,44
|
0,09
|
12/16
|
beta
|
[10]
|
Tp5
|
0,40
|
0,09
|
11/17
|
beta
|
[10]
|
RG-NACT; True favourable/unfavourable
|
Tp12-5
|
0,00
|
NA
|
-
|
fixed
|
assumption
|
HR RFS (RG-NACT vs. conventional-NACT)
|
0,50
|
0,20
|
0,50/0,20
|
Normal truncated
|
assumption
|
Conventional-NACT
|
Tp1
|
0,03
|
-
|
-
|
-
|
[10]
|
Tp2
|
0,06
|
-
|
-
|
-
|
[10]
|
Tp3
|
0,08
|
-
|
-
|
-
|
[10]
|
Tp4
|
0,05
|
-
|
-
|
-
|
[10]
|
Tp5
|
0,04
|
-
|
-
|
-
|
[10]
|
Breast cancer specific death
|
False favourable/unfavourable
|
Tp1
|
0,00
|
NA
|
-
|
fixed
|
assumption
|
Tp2
|
0,04
|
0,02
|
5/109
|
beta
|
[27]
|
Tp3
|
0,12
|
0,03
|
14/100
|
beta
|
[27]
|
Tp4
|
0,06
|
0,02
|
7/107
|
beta
|
[27]
|
Tp5
|
0,19
|
0,04
|
22/92
|
beta
|
[27]
|
HR BCSS (RG-NACT vs. conventional-NACT)
|
0,64
|
0,13
|
0,64/0,13
|
normal
|
[11]
|
Conventional-NACT
|
Tp1
|
0,00
|
NA
|
-
|
fixed
|
assumption
|
Tp2
|
0,06
|
-
|
-
|
-
|
[27]
|
Tp3
|
0,19
|
-
|
-
|
-
|
[27]
|
Tp4
|
0,09
|
-
|
-
|
-
|
[27]
|
Tp5
|
0,28
|
-
|
-
|
-
|
[27]
|
Utilities
|
Chemotherapy
|
0,62
|
0,04
|
94/58
|
beta
|
[39]
|
Neutropenia
|
0,53
|
0,01
|
557/488
|
beta
|
[40]
|
Anxiety
|
0,68
|
0,06
|
40/19
|
beta
|
[43]
|
Vomiting
|
0,52
|
0,08
|
17/16
|
beta
|
[41]
|
HFS
|
0,50
|
0,10
|
12/12
|
beta
|
[41]
|
Desquamation
|
0,59
|
0,01
|
1041/721
|
beta
|
[40]
|
CHF (average grade III/IV)
|
0,55
|
-
|
-
|
beta
|
[42]
|
CHF grade III
|
0,59
|
0,02
|
360/250
|
beta
|
[42]
|
CHF grade IV
|
0,51
|
0,05
|
52/50
|
beta
|
[42]
|
MDS/MLA
|
0,26
|
0,01
|
500/1423
|
beta
|
[55]
|
DFS
|
0,80
|
0,03
|
196/49
|
beta
|
[39]
|
R (average loco-regional and metastatic)
|
0,73
|
-
|
-
|
beta
|
[39]
|
Loco-regional relapse
|
0,68
|
0,03
|
226/104
|
beta
|
[39]
|
Metastatic relapse
|
0,78
|
0,04
|
104/30
|
beta
|
[39]
|
Scenarios and resource modelling
|
Incidental findings
| | | | | |
All
|
0,18
|
0,01
|
270/1265
|
beta
|
[29]
|
Malign
|
0,20
|
0,02
|
55/270
|
beta
|
[29]
|
MRI contraindications
| | | | | |
Impaired renal function
|
0.07
|
0.1c
|
0.45/5.54
|
beta
|
[49]
|
Gadolinium allergy
|
0.0003
|
0.01d
|
0.08/29
|
-
|
[44]
|
Body ferrous parts
|
0.58
|
0.1
|
0.26/4.21
|
beta
|
[45]
|
Claustrophobia
|
0.02
|
0.1
|
0.02/0.94
|
beta
|
[48]
|
Uptake
|
0.04
| |
20-100 %
|
fixed
|
assumption
|
MRI technologists with ATS
|
0.26
| |
-
|
fixed
|
[50]
|
Costs
|
Parameter
|
Unit costs
|
Unit measure
|
Mean resource use
|
Mean cost
|
SEe
|
Distribution
|
Source
|
Chemotherapy
| |
6×AC
|
Doxorubicin
|
€204
|
90 mg
|
5,3
|
€1306
|
€326
|
Gamma
|
[31]
|
Cyclophosphamide
|
€45
|
1080 mg
|
6,4
|
€239
|
€60
|
Gamma
|
[31]
|
Peg-filgrastim
|
€849
|
1 mg
|
6
|
€5096
|
€1274
|
Gamma
|
[56]
|
Pharmacy preparation
|
€45
|
Per course
|
6
|
€267
|
67
|
Gamma
|
NKI
|
Day care
|
€286
|
Day
|
6
|
€1718
|
€430
|
Gamma
|
[30]
|
Oncologist’s visit
|
€109
|
Visit
|
6
|
€653
|
€163
|
Gamma
|
[31]
|
Total
| | | |
€9279
| | | |
3×AC/3×DC
|
Doxorubicin
|
€204
|
90 mg
|
3,2
|
€653
|
€163
|
Gamma
|
[31]
|
Cyclophosphamide
|
€45
|
1080 mg
|
2,7
|
€120
|
€30
|
Gamma
|
[31]
|
Peg-filgrastim
|
€849
|
1 mg
|
3
|
€2548
|
€637
|
Gamma
|
[56]
|
Docetaxel
|
€959
|
108 mg
|
3,3
|
€3195
|
€799
|
Gamma
|
[31]
|
Capecitabine
|
€27
|
4500 mg
|
29,9
|
€821
|
€205
|
Gamma
|
[31]
|
Pharmacy preparation
|
€45
|
Per course
| |
€267
|
€67
|
Gamma
|
NKI
|
Day care
|
€286
|
Day
|
6
|
€1718
|
€430
|
Gamma
|
[30]
|
Oncologist’s visit
|
€109
|
Visit
|
6
|
€653
|
€163
|
Gamma
|
[31]
|
Total
| | | |
€9974
| | | |
Monitoring
|
MRI scan
|
Hospital costs
|
€163
|
Scan
|
1
|
€163
|
€41
|
Gamma
| |
Specialists fees
|
€52
|
Scan
|
1
|
€52
|
€13
|
Gamma
| |
Total
| | | |
€215
| | | |
Confirm incidental findings
|
€149
|
Episode
|
1
|
€149
|
€37
|
Gamma
| |
Chemotherapy related toxicities
|
Neutropenia
|
€14397
|
Episode
|
1
|
€14397
|
€425
|
Gamma
|
[35]
|
Vomiting
|
€92
|
Episode
|
1
|
€92
|
€23
|
Gamma
|
[57]
|
CHF
|
€18225
|
Episode
|
1
|
€18225
|
€4556
|
Gamma
|
[33]
|
MDS/MLA
|
€112946
|
Episode
|
1
|
€112946
|
€28236
|
Gamma
|
[58, 59]
|
Health states
|
DFS
|
In & out –patient
|
€2793
|
Episode
|
1
|
€2793
|
€563
|
Gamma
|
[36]
|
Drugs
|
€79
|
Episode
|
1
|
€79
|
€20
|
Gamma
|
[36]
|
Total
| | | |
€2872
| | | |
R
|
Local relapse
|
In & out -patient
|
€12497
|
Episode
|
1
|
€12497
|
€1692
|
Gamma
|
[36]
|
Drugs
|
€2336
|
Episode
|
1
|
€2336
|
€584
|
Gamma
|
[36]
|
Distant metastasis
| | | | | | | |
In & out -patient
|
€11645
|
Episode
|
1
|
€11645
|
€1346
|
Gamma
|
[36]
|
Drugs
|
€5772
|
Episode
|
1
|
€5772
|
€1443
|
Gamma
|
[36]
|
Total
| | | |
€16125
| | | |
BC death
|
€8296
|
Episode
|
1
|
€8296
|
€2074
|
Gamma
|
[36]
|