Format

Send to

Choose Destination
Genet Med. 2018 Sep;20(9):985-994. doi: 10.1038/gim.2017.231. Epub 2018 Jan 4.

Cost-effectiveness analysis of germ-line BRCA testing in women with breast cancer and cascade testing in family members of mutation carriers.

Author information

1
Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia. haitham.tuffaha@griffith.edu.au.
2
Centre for Applied Health Economics, School of Medicine, Griffith University, Nathan, Queensland, Australia. haitham.tuffaha@griffith.edu.au.
3
Pharmaceutical Evaluation Branch/Medical Specialist Services Branch, Australian Government Department of Health, Canberra, Australian Capital Territory, Australia.
4
Office of DVCR, University of Queensland, Brisbane, Australia, Queensland.
5
Centre for the Business and Economics of Health, University of Queensland, Brisbane, Queensland, Australia.
6
Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia.
7
Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales, Australia.
8
Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
9
Centre for Applied Health Economics, School of Medicine, Griffith University, Nathan, Queensland, Australia.

Abstract

PURPOSE:

To evaluate the cost-effectiveness of BRCA testing in women with breast cancer, and cascade testing in family members of BRCA mutation carriers.

METHODS:

A cost-effectiveness analysis was conducted using a cohort Markov model from a health-payer perspective. The model estimated the long-term benefits and costs of testing women with breast cancer who had at least a 10% pretest BRCA mutation probability, and the cascade testing of first- and second-degree relatives of women who test positive.

RESULTS:

Compared with no testing, BRCA testing of affected women resulted in an incremental cost per quality-adjusted life-year (QALY) gained of AU$18,900 (incremental cost AU$1,880; incremental QALY gain 0.10) with reductions of 0.04 breast and 0.01 ovarian cancer events. Testing affected women and cascade testing of family members resulted in an incremental cost per QALY gained of AU$9,500 compared with testing affected women only (incremental cost AU$665; incremental QALY gain 0.07) with additional reductions of 0.06 breast and 0.01 ovarian cancer events.

CONCLUSION:

BRCA testing in women with breast cancer is cost-effective and is associated with reduced risk of cancer and improved survival. Extending testing to cover family members of affected women who test positive improves cost-effectiveness beyond restricting testing to affected women only.

KEYWORDS:

BRCA testing; breast cancer; cascade testing; cost-effectiveness; ovarian cancer

PMID:
29300376
DOI:
10.1038/gim.2017.231
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Nature Publishing Group
Loading ...
Support Center