A cost-minimization analysis of a preventive testing strategy for relatives of patients with BRCA mutated ovarian cancer

  • Eugenio Di Brino Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Roma - Italia http://orcid.org/0000-0001-7964-3348
  • Matteo Ruggeri Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Roma - Italia https://orcid.org/0000-0002-5703-7424
  • Stefania Boccia Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma and Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma - Italia http://orcid.org/0000-0002-1864-749X
  • Nicoletta Cerana Associazione Contro il Tumore Ovarico, Milano - Italia
  • Domenica Lorusso Fondazione IRCCS Istituto Nazionale dei Tumori, Milano - Italia https://orcid.org/0000-0003-0981-0598
  • Dario Sacchini Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma and Istituto di Bioetica e Medical Humanities - Università Cattolica del Sacro Cuore, Roma - Italia https://orcid.org/0000-0002-1581-3018
  • Antonella Savarese Istituto Nazionale Tumori Regina Elena, Roma - Italia https://orcid.org/0000-0003-0011-6276
  • Liliana Varesco IRCCS Ospedale Policlinico San Martino, Genova - Italia https://orcid.org/0000-0003-4871-6668
  • Americo Cicchetti Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Roma - Italia https://orcid.org/0000-0002-4633-9195
Keywords: Costs, Healthcare expenditure, Ovarian cancer, Test BRCA

Abstract

Purpose: This study aims to estimate the cost-minimization strategy of a preventive testing strategy destined to relatives of patients with BRCA mutated cancer versus a no test strategy in Italia.

Methods: A BRCA testing pathway was designed by a panel of experts based on the MSTM Excel (2010) tool; the analysis was carried out considering the perspective of the Italian National Health Service. Two alternatives were considered: 1) preventive BRCA testing for relatives of patients affected by ovarian cancer carrying a BRCA1/BRCA2 mutation; 2) no test. Cost and effectiveness data, derived from literature and published sources validated by a Board of experts, were discounted using a discount factor equal to 3%. Probabilistic sensitivity analysis was performed.

Results: Considering an average cost of therapy for breast and ovarian cancer major of €90,000.00 per case, the economic impact related to the preventive testing strategy are equal to –€17,814,767.25. The sensitivity analysis confirms these results in the totality of the simulations performed.

Conclusions: Preventive genetic testing in relatives of patients affected by ovarian cancer is cost-effective and represents a sustainable cost for the National Healthcare System in Italia, also in the light of its reference values.

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Published
2020-04-04
How to Cite
Di BrinoE., RuggeriM., BocciaS., CeranaN., LorussoD., SacchiniD., SavareseA., VarescoL., & CicchettiA. (2020). A cost-minimization analysis of a preventive testing strategy for relatives of patients with BRCA mutated ovarian cancer. Global & Regional Health Technology Assessment, 7(1), 1-8. https://doi.org/10.33393/grhta.2020.557
Section
Original Research Article