{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:11:46Z","timestamp":1790079106587,"version":"4.0.1"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,11,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This study examined gene expression profile (GEP) use in relation to reimbursement policies and chemotherapy administration, both for patients with and without GEP indication. Women aged \u2265\u200918\u201369\u2009years and diagnosed with early\u2010stage breast cancer between January 2011 and June 2024 were selected from the Netherlands Cancer Registry. GEP use in relation to reimbursement policies and GEP result in relation to chemotherapy administration was analysed using flowcharts and a trend line. For patients with GEP indication, logistic regression analyses were conducted to determine if the reimbursement periods influenced the GEP use, and GEP use was analysed per region in the Netherlands and incidence year using trend lines. In total, 138,765 patients were included. Among 17,525 patients with GEP indication, proportions of patients who received a GEP were higher during retrospective reimbursement (25%) and publicly known reimbursement (37%) compared with no reimbursement (9%) and differed across regions in the Netherlands. Proportions of patients who did not receive chemotherapy were higher for patients who had a low\u2010risk MammaPrint (93%) or Oncotype DX (97%) result compared with patients who had a high\u2010risk MammaPrint (17%) or Oncotype DX (15%) result. Among 13,003 patients with GEP indication who did not receive GEP, 52% did receive chemotherapy. Approximately one\u2010third of patients who met GEP criteria and were eligible for publicly known reimbursement received a GEP. Appropriate follow\u2010up steps and further research seem required to analyse reasons for not ordering a GEP in times of reimbursement, since GEP results help chemotherapy decision\u2010making.<\/jats:p>","DOI":"10.1002\/ijc.70571","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T06:15:38Z","timestamp":1780640138000},"page":"2485-2497","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Reimbursement on the Utilisation of Gene Expression Profiles and Chemotherapy Decision\u2010Making in Dutch Breast Cancer Patients: A Population\u2010Based Study"],"prefix":"10.1002","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7327-5916","authenticated-orcid":false,"given":"Joyce","family":"Meijer","sequence":"first","affiliation":[{"name":"Department of Research and Development Netherlands Comprehensive Cancer Organisation (IKNL)  Utrecht the Netherlands"},{"name":"Department of Health Technology and Services Research Technical Medical Centre, University of Twente  Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke","family":"Hermanns","sequence":"additional","affiliation":[{"name":"Department of Health Technology and Services Research Technical Medical Centre, University of Twente  Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0980-6652","authenticated-orcid":false,"given":"Rhod\u00e9","family":"Bijlsma","sequence":"additional","affiliation":[{"name":"Division of Imaging and Oncology University Medical Center Utrecht, Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5846-0531","authenticated-orcid":false,"given":"Hedwig M.","family":"Blommestein","sequence":"additional","affiliation":[{"name":"Erasmus School of Health Policy &amp; Management  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5549-324X","authenticated-orcid":false,"given":"Desiree H. 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G.","family":"van den Bongard","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Amsterdam UMC  Amsterdam the Netherlands"},{"name":"Cancer Center Amsterdam, Cancer Treatment and Quality of Life\/Cancer Biology and Immunology  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0882-9086","authenticated-orcid":false,"given":"Thijs","family":"van Dalen","sequence":"additional","affiliation":[{"name":"Department of Surgery Erasmus Medical Centre  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0658-2745","authenticated-orcid":false,"given":"Paul J.","family":"van Diest","sequence":"additional","affiliation":[{"name":"Department of Pathology University Medical Center Utrecht  Utrecht the 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