A Cost Decision Model Supporting Treatment Strategy Selection in BRCA1/2 Mutation Carriers in Breast Cancer

Abstract

In this paper, a cost decision-making model that compares the healthcare costs for diverse treatment strategies is built for BRCA-mutated women with breast cancer. Moreover, this model calculates the cancer treatment costs that could potentially be prevented, if the treatment strategy with the lowest total cost, along the entire lifetime of the patient, is chosen for high-risk women with breast cancer. The benchmark of the healthcare costs for diverse treatment strategies is selected in the presence of uncertainty, i.e., considering, throughout the lifetime of the patient, the risks and complications that may arise in each strategy and, therefore, the costs associated with the management of such events. Our results reveal a clear economic advantage of adopting the cost decision-making model for benchmarking the healthcare costs for various treatment strategies for BRCA-mutated women with breast cancer. The cost savings were higher when all breast cancer patients underwent counseling and genetic testing before deciding on any diagnostic-therapeutic path, with a probability of obtaining savings of over 75%.

Uptake Rates of Risk-Reducing Surgeries for Women at Increased Risk of Hereditary Breast and Ovarian Cancer Applied to Cost-Effectiveness Analyses: A Scoping Systematic Review

“…Among these, nineteen health economic modeling studies fulfilled the inclusion criteria [ 9 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. Four studies were excluded due to insufficient reporting of the uptake rates of risk-reducing surgeries [ 36 ] because a perfect uptake of surgery was assumed [ 37 , 38 ] or because of an inappropriate presentation of the model result [ 39 ]. More information on the excluded studies is provided in the Supplementary Materials (Table S3) .…”

Lean Perspectives in an Organizational Change in a Scientific Direction of an Italian Research Institute: Experience of the Cancer Institute of Bari

“…Authors such as Akmal and colleagues [2] in their research underline how healthcare organizations (HOs) constantly face challenges aimed at delivering more efficient and effective care to patients [3,4]. Internal inefficiencies may involve delays or insufficient maintenance [5][6][7]; thus, effective health management strategies that rationalize resources and influence clinical choices are crucial today [8]. The term "Lean Healthcare" reflects the necessity to be more attentive toward the efficiency and the final satisfaction of patients, which may be achieved by avoiding delays, errors, or inappropriate and redundant procedures [9].…”