Early health technology assessment of magnetic resonance-guided high intensity focused ultrasound ablation for the treatment of early-stage breast cancer

Floortje M Knuttel, Sèvrin E M Huijsse, Talitha L Feenstra, Chrit T W Moonen, Maurice A A J van den Bosch, Erik Buskens, Marcel J W Greuter, Geertruida H de Bock

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Abstract

BACKGROUND: Magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) ablation is in development for minimally invasive treatment of breast cancer. Cost-effectiveness has not been assessed yet. An early health technology assessment was performed to estimate costs of MR-HIFU ablation, compared to breast conserving treatment (BCT).

METHODS: An MR-HIFU treatment model using the dedicated MR-HIFU breast system (Sonalleve, Philips Healthcare) was developed. Input parameters (treatment steps and duration) were based on the analysis of questionnaire data from an expert panel. MR-HIFU experts assessed face validity of the model. Data collected by questionnaires were compared to published data of an MR-HIFU breast feasibility study. Treatment costs for tumours of 1 to 3 cm were calculated.

RESULTS: The model structure was considered of acceptable face validity by consulted experts, and questionnaire data and published data were comparable. Costs of MR-HIFU ablation were higher than BCT costs. MR-HIFU best-case scenario costs exceeded BCT costs with approximately €1000. Cooling times and breathing correction contributed most to treatment costs.

CONCLUSIONS: MR-HIFU ablation is currently not a cost-effective alternative for BCT. MR-HIFU experience is limited, increasing uncertainty of estimations. The potential for cost-effectiveness increases if future research reduces treatment durations and might substantiate equal or improved results.

Original languageEnglish
JournalJournal of therapeutic ultrasound
Volume5
Issue number23
DOIs
Publication statusPublished - 1-Aug-2017

Keywords

  • Journal Article
  • Breast cancer
  • Cost-effectiveness
  • Breast-conserving therapy
  • CONSERVING SURGERY
  • METAANALYSIS
  • THERMOMETRY

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