The economic value of knowing BRCA status: BRCA testing for optimizing treatment in recurrent epithelial ovarian cancer

ABSTRACT

Background

This study aimed to estimate the incremental lifetime effects, costs, and net monetary benefit (NMB) of knowing BRCA information for recurrent ovarian cancer (ROC) patients in a given year and the cumulative savings of yearly hypothetical 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 average net monetized benefit of knowing BRCA status. The net monetized value (cumulative INMB) of knowing BRCA information was estimated by multiplying the INMB with the eligible ROC patients in year 2020 and extended for potential ROC patients over 16 yearly hypothetical cohorts of ROC patients

Results

Knowing BRCA information for ROC patients provided an additional monetized value of $3,528 in (payer) and $3,194 (society). Escalated to all ROC patients in the U.S. and future incidence ROC estimates, knowing BRCA information resulted in a lifetime cumulative INMB of $35.6 million (payer) and $32.2 million (society) for the 2020 cohort; and yielded an accumulated value of $97.3 million (payer) and $88.0 million (society) over 16 yearly hypothetical cohorts of ROC patients

Conclusions

The economic value of knowing BRCA status of all U.S. ROC patients provides short-term and long-term evidence for optimizing treatment

KEYWORDS:

• BRCA
• ovarian cancer
• olaparib
• recurrent epithelial ovarian
• BRCA1
• BRCA2
• cost-effectiveness

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 analyzed 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/10.1080/14737167.2023.2169136