Universität zu Köln

Lourencao, Marina, Simoes Correa Galendi, Julia, Reis Galvao, Henrique de Campos, Antoniazzi, Augusto Perazzolo, Grasel, Rebeca Silveira, Carvalho, Andre Lopes ORCID: 0000-0001-7214-6402, Mauad, Edmundo Carvalho, Oliveira, Jorge Henrique Caldeira de, Reis, Rui Manuel, Mandrik, Olena ORCID: 0000-0003-3755-3031 and Palmero, Edenir Inez (2022). Cost-Effectiveness of BRCA 1/2 Genetic Test and Preventive Strategies: Using Real-World Data From an Upper-Middle Income Country. Front. Oncol., 12. LAUSANNE: FRONTIERS MEDIA SA. ISSN 2234-943X

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Abstract

Although BRCA1/2 genetic testing in developed countries is part of the reality for high-risk patients for hereditary breast and ovarian cancer (HBOC), the same is not true for upper-middle-income countries. For that reason, this study aimed to evaluate whether the BRCA1/2 genetic test and preventive strategies for women at high risk for HBOC are cost-effective compared to not performing these strategies in an upper-middle-income country. Adopting a payer perspective, a Markov model with a time horizon of 70 years was built to delineate the health states for a cohort of healthy women aged 30 years that fulfilled the BRCA1/2 testing criteria according to the guidelines. Transition probabilities were calculated based on real-world data of women tested for BRCA1/2 germline mutations in a cancer reference hospital from 2011 to 2020. We analyzed 275 BRCA mutated index cases and 356 BRCA mutation carriers that were first- or second-degree relatives of the patients. Costs were based on the Brazilian public health system reimbursement values. Health state utilities were retrieved from literature. The BRCA1/2 genetic test and preventive strategies result in more quality-adjusted life years (QALYs) and costs with an incremental cost-effectiveness ratio of R$ 11,900.31 (U$ 5,504.31)/QALY. This result can represent a strong argument in favor of implementing genetic testing strategies for high-risk women even in countries with upper-middle income, considering not only the cancer prevention possibilities associated with the genetic testing but also its cost-effectiveness to the health system. These strategies are cost-effective, considering a willingness-to-pay threshold of R$ 25,000 (U$ 11,563.37)/QALY, indicating that the government should consider offering them for women at high risk for HBOC. The results were robust in deterministic and probabilistic sensitivity analyses.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lourencao, Marina UNSPECIFIED UNSPECIFIED UNSPECIFIED Simoes Correa Galendi, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Reis Galvao, Henrique de Campos UNSPECIFIED UNSPECIFIED UNSPECIFIED Antoniazzi, Augusto Perazzolo UNSPECIFIED UNSPECIFIED UNSPECIFIED Grasel, Rebeca Silveira UNSPECIFIED UNSPECIFIED UNSPECIFIED Carvalho, Andre Lopes UNSPECIFIED orcid.org/0000-0001-7214-6402 UNSPECIFIED Mauad, Edmundo Carvalho UNSPECIFIED UNSPECIFIED UNSPECIFIED Oliveira, Jorge Henrique Caldeira de UNSPECIFIED UNSPECIFIED UNSPECIFIED Reis, Rui Manuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Mandrik, Olena UNSPECIFIED orcid.org/0000-0003-3755-3031 UNSPECIFIED Palmero, Edenir Inez UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-689490
DOI:	10.3389/fonc.2022.951310
Journal or Publication Title:	Front. Oncol.
Volume:	12
Date:	2022
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	2234-943X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BREAST-CANCER; OVARIAN-CANCER; NO EVIDENCE; UTILITIES; QUALITY; MODELS; RISK; LIFE Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68949