Economic value of knowing BRCA status: BRCA testing for prostate cancer prevention and optimal treatment

ABSTRACT

Background

We aimed to estimate the incremental lifetime effects, costs, and net-monetary-benefit (NMB) of knowing BRCA information by testing of patients with low-risk localized prostate cancer (PCa) in the US and guiding subsequent screening and treatment, 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.’ We also estimated the expected value of perfect information.

Methods

The incremental NMB (INMB) quantified the monetized benefit per person of knowing BRCA status. The net-monetized-value of knowing BRCA information was estimated by multiplying the INMB with the eligible population.

Results

The INMBs of knowing BRCA information were $43,357 (payer) and $43,487 (society). in payer and societal perspectives, respectively. Escalated to the eligible patients in 2020, knowing BRCA status resulted in net monetized lifetime value of $1.7 billion (payer and society) for the 2020 cohort; and yielded accumulated net-monetized-value of $28.0 billion (payer) and $28.1 billion (society) over 16 yearly cohorts of eligible PCa patients.

Conclusions

The economic value of knowing BRCA status for all low-risk localized PCa patients in the US provides short-term and long-term evidence for BRCA testing to screen early and optimize treatment.

KEYWORDS:

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

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/10.1080/14737167.2023.2169137

Additional information

Funding

This paper was not funded.