A systematic review on the cost-effectiveness of genetic-based screen-and-treat strategies suggests that targeted BRCA or multiple gene screening is cost-effective to prevent breast and ovarian cancer (Value Health. 2021 Feb;24(2):303-312. doi:10.1016/j.jval.2020.09.016.).
“Targeted genetic testing is a tool to identify women at increased risk of gynaecological cancer,” explained Andreas Koldenhoff, MD, Department of Anaesthesiology, Ruhr-Universität Bochum (Bochum, Germany).
This study aimed to determine the cost-effectiveness of targeted genetic testing for breast and ovarian cancer through the evaluation of results and quality of existing modeling studies.
The MEDLINE and Centre for Reviews and Dissemination databases were searched for health economic modeling evaluations of targeted gentic-based screen-and-treat strategies to prevent inheritable breast and ovarian cancer. Incremental cost-effectiveness ratios (ICERs) were compared.
A total of 18 studies were identified. From the payer perspective, BRCA screening for high-risk women without cancer was associated with an ICER of up to $21,700 per quality-adjusted life year (QALY) compared with no testing.
Among studies that evaluated BRCA screening in women with cancer plus their unaffected relatives, ICERs were between $6500 per QALY to $50,200 per QALY compared with no testing.
Compared with targeted BRCA testing, multigene testing in women without cancer resulted in an ICER of $51,800 per QALY and multigene testing for women with cancer plus their unaffected relatives resulted in an ICER of $69,600 per QALY for women in the United States.
“Targeted BRCA or multiple gene screening is likely to be cost-effective,” concluded Dr Koldenhoff and colleagues, adding that the development of a reference model “may serve as a tool for validation of present and future cost-effectiveness models.”—Marta Rybczynski
