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| Content Provider | frontiers |
|---|---|
| Author | Lourenção, Marina Simões Correa Galendi, Julia Galvão, Henrique de Campos Reis Antoniazzi, Augusto Perazzolo Grasel, Rebeca Silveira Carvalho, André Lopes Mauad, Edmundo Carvalho Oliveira, Jorge Henrique Caldeira de Reis, Rui Manuel Mandrik, Olena Palmero, Edenir Inêz |
| Abstract | Although the BRCA 1/2 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 BRCA 1/2 germline mutations in a cancer reference hospital from 2011 to 2020. We analysed 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 states 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. |
| ISSN | 2234943X |
| DOI | 10.3389/fonc.2022.951310 |
| Volume Number | 12 |
| Journal | Frontiers in Oncology |
| Language | English |
| Publisher Date | 2022-07-11 |
| Access Restriction | Open |
| Subject Keyword | Cost-Effectiveness Breast cancer Preventive strategies BRCA genetic test Ovarian cancer |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cancer Research Oncology |
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