Cost-Effectiveness Analysis of Germline and Somatic BRCA Testing in Patients With Advanced Ovarian Cancer

Abstract

Background: BRCA testing is necessary for establishing a management strategy for ovarian cancer. Several BRCA testing strategies, including germline and somatic testing, are implemented in clinical practice in Korea. We aimed to comparatively evaluate their costeffectiveness from patients' perspective. Methods:We developed a decision model comprising five BRCA testing strategies implemented in Korea: (1) germline testing first, followed by somatic tumor testing for patients without a germline variant; (2) somatic testing first, followed by germline testing for patients with a variant detected by somatic testing; (3) both germline and somatic testing; (4) germline testing alone; and (5) somatic testing alone, with no testing as the comparator. One-way sensitivity analysis was conducted to test the uncertainty of key parameters.Results: Assuming a willingness-to-pay of $20,000 per progression-free life-year gain (PF-LYG), all five strategies were considered cost-effective. Strategy 4 was the most cost-effective option, with an incremental cost-effectiveness ratio (ICER) of $2,547.7 per PF-LYG, followed by strategy 1, with an ICER of $3,978.4 per PF-LYG. Even when the parameter values were varied within the possible range, the ICERs of all strategies did not exceed the willingness-to-pay threshold.Conclusions: Considering the importance of knowing a patient's BRCA gene status, germline testing first, followed by somatic testing, may be a reasonable option.

Textural and Conventional Pretherapeutic [18F]FDG PET/CT Parameters for Survival Outcome Prediction in Stage III and IV Oropharyngeal Cancer Patients

“…New cancer treatment techniques are currently being studied to improve patient survival [34][35][36]. However, the same technique may have different results in patients diagnosed with the same cancer.…”

Cost-effective BRCA Testing in Advanced Ovarian Cancer

“…This issue was addressed in a recent study by Jang, et al . [ 11 ]. They assessed the cost-effectiveness of BRCA testing strategies followed by PARP inhibitor maintenance therapy based on the National Health Insurance system in Korea.…”