Economic Modelling of Screen-and-Treat Strategies for Brazilian Women at Risk of Hereditary Breast and Ovarian Cancer.

Applied Health Economics and Health Policy
Julia Simoes Correa-GalendiDirk Müller

Abstract

Clinical evidence supports the use of genetic counselling and BRCA1/2 testing for women at risk for hereditary breast and ovarian cancer. Currently, screen-and-treat strategies are not reimbursed in the Brazilian Unified Healthcare System (SUS). The aim of this modelling study was to evaluate the cost effectiveness of a gene-based screen-and-treat strategy for BRCA1/2 in women with a high familial risk followed by preventive interventions compared with no screening. Adopting the SUS perspective, a Markov model with a lifelong time horizon was developed for a cohort of healthy women aged 30 years that fulfilled the criteria for BRCA1/2 testing according to the National Comprehensive Cancer Network (NCCN) guideline. For women who tested positive, preventive options included intensified surveillance, risk-reducing bilateral mastectomy and bilateral salpingo-oophorectomy. The Markov model comprised the health states 'well', 'breast cancer', 'death' and two post-cancer states. Outcomes were the incremental costs per quality-adjusted life-year (QALY) and the incremental costs per life-year gained (LYG). Data were mainly obtained by a literature review. Deterministic and probabilistic sensitivity analyses were performed to assess the ...Continue Reading

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Citations

Sep 26, 2020·Nature Reviews. Clinical Oncology·Ophira GinsburgPaul Brennan
Jan 19, 2021·The Breast : Official Journal of the European Society of Mastology·Fatima CardosoPhilip Poortmans
Aug 30, 2021·Hereditary Cancer in Clinical Practice·Zahra MeshkaniAli Ghanbari Motlagh
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Methods Mentioned

BETA
prophylactic surgery
prophylactic surgeries

Software Mentioned

AdViSHE
DATASUS Tabnet
HISPANEL
TreeAge® ProSuite
TreeAge Pro

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