Economic modeling of risk-adapted screen-and-treat strategies in women at high risk for breast or ovarian cancer

The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care
Dirk MüllerKerstin Rhiem

Abstract

The 'German Consortium for Hereditary Breast and Ovarian Cancer' (GC-HBOC) offers women with a family history of breast and ovarian cancer genetic counseling. The aim of this modeling study was to evaluate the cost-effectiveness of genetic testing for BRCA 1/2 in women with a high familial risk followed by different preventive interventions (intensified surveillance, risk-reducing bilateral mastectomy, risk-reducing bilateral salpingo-oophorectomy, or both mastectomy and salpingo-oophorectomy) compared to no genetic test. A Markov model with a lifelong time horizon was developed for a cohort of 35-year-old women with a BRCA 1/2 mutation probability of ≥ 10%. The perspective of the German statutory health insurance (SHI) was adopted. The model included the health states 'well' (women with increased risk), 'breast cancer without metastases', 'breast cancer with metastases', 'ovarian cancer', 'death', and two post (non-metastatic) breast or ovarian cancer states. Outcomes were costs, quality of life years gained (QALYs) and life years gained (LYG). Important data used for the model were obtained from 4380 women enrolled in the GC-HBOC. Compared with the no test strategy, genetic testing with subsequent surgical and non-surgical tr...Continue Reading

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Citations

Dec 6, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jinani Jayasekera, Jeanne S Mandelblatt
Feb 2, 2021·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Andreas KoldehoffDirk Müller
Aug 30, 2021·Hereditary Cancer in Clinical Practice·Zahra MeshkaniAli Ghanbari Motlagh

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