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06 Jan 2015

Submission for Oncotype DX Medicare rebate

Breast Cancer Network Australia (BCNA) has provided a submission to the Medical Services Advisory Committee (MSAC) in support of an application for a Medicare rebate for the Oncotype DX Breast Cancer Assay.

The Oncotype DX test is a tool to assist women with certain types of breast cancer to make their decision on whether or not to have chemotherapy treatment. This specialised test analyses 21 genes within the tumour and makes a prediction about the likelihood of the breast cancer recurring. If the test shows there is a high risk of recurrence, chemotherapy may be recommended. If the test shows a low risk of recurrence, chemotherapy may be able to be avoided and other less invasive treatments, such as radiotherapy and hormone therapy, can be undertaken.

Oncotype DX is not suitable for all types of breast cancer. It is useful only in women (pre and post-menopausal) whose tumours are oestrogen receptor positive (ER+), HER2-negative and whose lymph nodes are either negative (i.e. where the cancer has not spread to the lymph nodes) or positive up to 3 nodes only.

The test is done only in the USA and is not currently covered by Medicare.

The application being considered by MSAC is not restricted to the Oncotype DX test, but refers more generally to gene expression profiling of 21 genes in breast cancer assay to quantify the risk of disease recurrence and predict adjuvant chemotherapy benefit. This means that, should the application be approved, any new 21 gene assay tests that are developed will not need to go through the MSAC process to be eligible for a Medicare rebate.

BCNA thanks the women who assisted us with the development of this submission and gave us permission to use their quotes.

More information

For more information on Oncotype DX, you might like to: