The economic value of knowing BRCA status: universal BRCA testing for breast cancer prevention

ABSTRACT

Background

This study aimed to estimate the incremental lifetime effects, costs, and net monetary benefit (NMB) of knowing BRCA information by universal genetic testing of all US women without breast cancer turning 40 in a given year, and the cumulative savings or losses of yearly cohort testing over 16 years. We compared two strategies: (1) ‘with BRCA information’ and (2) ‘without BRCA information.’

Methods

Incremental NMB (INMB) was calculated as the monetized benefit per person of knowing BRCA status. The net monetized value (cumulated INMB) of knowing BRCA information was estimated by multiplying the INMB with the eligible population or the year 2020 cohort of US women age 40 and extended for a total of 16 yearly cohorts.

Results

Universal testing of the female population at the age of 40 in a given year provided aan INMB of $663/person (payer) and $1,006/person (society).Escalated to the U.S. population of women age 40 , knowing BRCA status resulted in lifetime cumulated INMB of $1.3 billion (payer) and $2.0 billion (society) for the 2020 cohort; and yielded accumulated monetized value of $18.3 billion (payer) and $27.6 billion (society) over 16 yearly cohorts of 40-year-old women.

Conclusions

The universal testing for BRCA status of all US women at age 40 provides compelling short-term and long-term economic value.

KEYWORDS:

• BRCA
• breast cancer
• cost-effectiveness
• genetic testing
• value of information

Acknowledgments

The authors thank three anonymous reviewers for their insightful comments and helpful suggestions.

Declaration of interest

M Oh is working at Astellas in a position unrelated to the present work. A McBride is now working at Bristol Myers Squibb in a position unrelated to the present work. S Bhattacharjee is now working at Otsuka Pharmaceutical Development & Commercialization Inc in a position unrelated to the present work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

M Oh: designed the model and the framework and analysed the data.

I Abraham: guided the study and were in charge of overall direction.

A McBride, S Bhattacharjee, M Slack and J Jeter: contributed to the interpretation of the results. All authors approved the final manuscript for publication.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2169135

Additional information

Funding

This paper was not funded.