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Table 3 Input model parameters

From: Cost-effectiveness and resource use of implementing MRI-guided NACT in ER-positive/HER2-negative breast cancers in The Netherlands

Parameter

mean

SE

Parametersa

Distribution

Source

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]

  1. Abbreviations: SE standard error, AC cyclophosphamide, doxorubicine; DC docetaxel, capecitabine; HFS hand-food-syndrome, CFH congestive heart failure, AML/ADM acute myeloid leukaemia/myelodysplastic syndrome, MRI magnetic resonance imaging, tp transition probability, HR hazard ratio, RG-NACT response guided neoadjuvant chemotherapy, NACT neoadjuvant chemotherapy, DFS disease free survival, R relapse, RFS relapse free survival, BCSS breast cancer specific survival, BC breast cancer, ATS acute transition symptom, NKI Netherlands Cancer Institute
  2. aDirichlet distribution: mean/SE, Beta distribution: α/β, Normal distribution: mean/SE
  3. bWe derived these proportions with the dataset of Rigter et al., as explained in the section ‘clinical input parameters’ and following the definitions of ‘Table 2’
  4. cWe assumed a SE = 0.1
  5. dWe assumed a SE = 0.01
  6. eWe assumed SE = 0.25 when this was not available from literature
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BMC Cancer

ISSN: 1471-2407

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