A cost-utility analysis of BRCA1 and BRCA2 testing in high-risk breast cancer patients and family members in Thailand
A cost-effective policy in resource-limited settings
Bibliographic Data
| ID | 22068374 |
|---|---|
| Authors | Pongtawat Lertwilaiwittaya (0000-0002-8808-3829, Siriraj Hospital), Narisa Tantai (Siriraj Hospital), Satanun Maneeon (Siriraj Hospital), Sophittha Kongbunrak (Siriraj Hospital), Nongyao Nonpanya (University of Alabama at Birmingham), Anna C E Hurst, Anna Hurst (0000-0002-9765-9703, University of Alabama at Birmingham), Varalak Srinonprasert (0000-0001-5311-7657, Siriraj Hospital, corresponding author), Manop Pithukpakorn (0000-0003-3611-5718, Siriraj Hospital, corresponding author) |
| Year | 2023 |
| Volume | 11 |
| Pages | 1257668-1257668 |
| Publication date | 2023-12-14 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2023.1257668 |
| PMID | 38162618 |
| OpenAlex | W4389733275 |
| Language | EN |
| Citations received | 1 |
| References cited | 26 |
Background: variants (gBRCA) in high-risk breast cancer patients is known to be cost-effective in high-income countries. Nationwide adoption of genetics testing in high-risk breast cancer population remains poor. Our study aimed to assess gBRCA health economics data in the middle-income country setting of Thailand. Methods: Decision tree and Markov model were utilized to assess cost-utility between the testing vs. no-testing groups from a societal and lifetime perspective and lifetime. We interviewed 264 patients with breast/ovarian cancer and their family members to assess relevant costs and quality of life using EQ-5D-5L. One-way sensitivity, probabilistic sensitivity (Monte Carlo simulation), and budget impact analyses were done to estimate the outcome under Thailand's Universal Health Coverage scheme. Results: The predicted lifetime cost and Quality-adjusted Life Years (QALY) for those with breast cancer were $13,788 and 10.22 in the testing group and $13,702 and 10.07 in the no-testing group. The incremental cost-effectiveness ratio for gBRCA testing in high-risk breast cancer patients was $573/QALY. The lifetime cost for the family members of those with gBRCA was $14,035 (QALY 9.99), while the no-testing family members group was $14,077 (QALY 9.98). Performing gBRCA testing in family members was cost-saving. Conclusion: Cost-utility analysis demonstrated a cost-effective result of gBRCA testing in high-risk breast cancer patients and cost-saving in familial cascade testing. The result was endorsed in the national health benefits package in 2022. Other middle-income countries may observe the cost-effective/cost-saving aspects in common genetic diseases under their national health schemes
Breast cancer · Cancer · Cost effectiveness · Environmental health · Genetic testing · Population · Quality-adjusted life year · BRCA gene mutations in cancer · Genomics and Rare Diseases · Health Systems, Economic Evaluations, Quality of Life · Medicine · Internal Medicine · Oncology
| Citations per year | 1 |
|---|---|
| Citation span | 2025 - 2025 (1) |
| Highly cited | No |