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Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 8/2019

Open Access 01-08-2019 | Breast Cancer | Research Article

Cost–utility analysis of germline BRCA1/2 testing in women with high-grade epithelial ovarian cancer in Spain

Authors: Carlota Moya-Alarcón, Almudena González-Domínguez, Susana Simon, Inés Pérez-Román, Antonio González-Martín, Eloisa Bayo-Lozano, Ana Beatriz Sánchez-Heras

Published in: Clinical and Translational Oncology | Issue 8/2019

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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.
Appendix
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Metadata
Title
Cost–utility analysis of germline BRCA1/2 testing in women with high-grade epithelial ovarian cancer in Spain
Authors
Carlota Moya-Alarcón
Almudena González-Domínguez
Susana Simon
Inés Pérez-Román
Antonio González-Martín
Eloisa Bayo-Lozano
Ana Beatriz Sánchez-Heras
Publication date
01-08-2019
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 8/2019
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-018-02026-2

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