Cost-utility analysis of germline BRCA1/2 testing in women with high-grade epithelial ovarian cancer in Spain.
Clin Transl Oncol
; 21(8): 1076-1084, 2019 Aug.
Article
em En
| MEDLINE
| ID: mdl-30617925
ABSTRACT
PURPOSE:
Germline mutations in BRCA1 and/or BRCA2 genes (gBRCA1/2m) are associated with an increased risk of breast cancer (BC) and ovarian cancer (OC). The aim of this study was to estimate the efficiency of providing germline BRCA1/2 testing to high-grade epithelial ovarian cancer (HGEOC) patients without family history of OC or BC and the subsequent testing and management of their relatives with gBRCA1/2m in Spain. METHODS/PATIENTS Incident HGEOC patients without family history of OC or BC who were gBRCA1/2m carriers and their relatives were simulated in a 50-year time horizon. The study compared two scenarios BRCA1/2 testing vs no testing, using the perspective of the Spanish National Health Service. Cancer risk among gBRCA1/2m carriers was estimated based on their age and whether they had undergone risk-reducing surgeries. Direct healthcare costs and utilities of patients who developed EOC and BC were also included. A probabilistic sensitivity analysis (PSA) with 5 thousand simulations was developed considering ± 25% of the base-case value.RESULTS:
The BRCA1/2-testing scenario amounted to 13,437,897.43 while the no-testing scenario amounted to 12,053,291.17. It was estimated that the screening test improved the quality of life among the patients' relatives by 43.8 quality-adjusted life years (QALYs). The incremental cost-utility ratio (ICUR) was 31,621.33/QALY in the base case. The PSA showed that 89.12% of the simulations were below the 50,000/QALY threshold.CONCLUSION:
Providing this screening test to HGEOC patients and their relatives is cost-effective and it allows one to identify a target population with high risk of cancer to provide effective prevention strategies.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Testes Genéticos
/
Custos de Cuidados de Saúde
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Análise Custo-Benefício
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Mutação em Linhagem Germinativa
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Proteína BRCA1
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Proteína BRCA2
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Carcinoma Epitelial do Ovário
Tipo de estudo:
Diagnostic_studies
/
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article