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Agendia's MammaPrint Breast Cancer Risk Test Cost-Effective in Multi-Country Analysis

NEW YORK – MammaPrint, a breast cancer recurrence test sold by Amsterdam-headquartered Agendia, cut healthcare costs in five out of six countries evaluated and was cost-effective in all six, according to an analysis published in the latest issue of the European Journal of Cancer.

The multi-country analysis, which included the US, Belgium, France, Germany, the Netherlands, and the UK, was based on the MINDACT trial. The analysis showed that using the 70-gene assay to guide chemotherapy decisions for early-stage breast cancer patients incurred savings for the healthcare systems in all the countries except in the UK, though it was deemed cost-effective there.

The MINDACT study initially showed that patients with estrogen receptor-positive, HER2-negative breast cancer who were considered high-risk according to clinical-pathological assessment, but who had a low-risk gene signature score according to MammaPrint, could potentially forgo chemotherapy with minimal differences in rates of survival without distant metastases compared to those who received chemo. 

To conduct the cost-effectiveness analysis, researchers led by Wim van Harten from the Netherlands Cancer Institute factored in total costs, clinical outcomes, and quality-adjusted life years. Costs for the 70-gene signature, including transport, local specimen processing, and value-added tax, were separately assessed for the six countries evaluated and compared with costs of clinical-pathological risk assessment using the modified Adjuvant! Online decision tool.

Treatment costs were obtained from respective national drug databases, literature, and governmental white papers on coverage decisions. Ultimately, the analysis showed that annual national cost savings with MammaPrint were €4.2 million ($5.0 million) in Belgium, €24.7 million in France, €45.1 million in Germany, €12.7 million in the Netherlands, and $244 million in the US.

The UK was the only country in which the analysis did not definitively show MammaPrint to be cost-saving, although the researchers still deemed the assay cost-effective. The variation in the range of savings was attributed to differences in country-specific treatment guidelines and costs. Because chemotherapy costs are low in the UK, the use of MammaPrint might be cost-effective up to a willingness-to-pay threshold of £30,000, the authors wrote.

"Since its initial five-year data analysis was published in 2016, the MINDACT study has continued to prove MammaPrint's clinical utility," Bastiaan van der Baan, Agendia's chief clinical and business development officer, said in a statement. "We are encouraged to see that MammaPrint not only saves a patient from experiencing the toxicity of chemotherapy, but also that it can save health systems the associated financial expenses."

According to Agendia, nine-year follow-up results from MINDACT, expected to be published in the coming months, will further validate MammaPrint's clinical utility in guiding chemotherapy de-escalation in this patient population.

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