Result card

  • ECO4: What is the impact of uPA/PAI-1 (Femtelle), OncotypeDx™ or MammaPrint® on indirect costs?

What is the impact of uPA/PAI-1 (Femtelle), OncotypeDx™ or MammaPrint® on indirect costs?

Authors: Isaura Vieira, Mirella Corio, Maria Rosaria Perrini, Matteo Ruggeri

Internal reviewers: Hanan Bell, Marco Oradei, Michelle O'Neill, Patricia Harrington, Kristi Liiv

Selected studies extracted from the basic literature search were analysed. Only two economic studies {1; 7} were found to be relevant to this question.

The study perspective selected in the scope—societal perspective—requires consideration of the inclusion of indirect costs in the model.

It is known that both chemotherapy treatment, mainly its adverse effects, and cancer recurrence can generate productivity loss in active women. Only two of the studies referred to indirect costs and they did not consider the inclusion of productivity losses due to the perspective adopted (payer’s perspective) {1; 7}.

The use of prognostic tests is expected to have a positive impact on indirect costs if, from its utilisation, there is a resulting decrease in the utilisation of chemotherapy and a decrease in cancer recurrence. There is not enough high quality evidence to assess this impact.

Further evidence development is needed to address this question.

Vieira I et al. Result Card ECO4 In: Vieira I et al. Costs and economic evaluation In: Jefferson T, Vicari N, Raatz H [eds.]. Prognostic tests for breast cancer recurrence (uPA/PAI-1 [FEMTELLE], MammaPrint, Oncotype DX ) [Core HTA], Agenzia nationale per i servizi sanitari regionali (, Italy ; 2013. [cited 2 December 2022]. Available from: