. Author manuscript; available in PMC: 2011 Apr 1.

Published in final edited form as: Genet Med. 2010 Apr;12(4 Suppl):S15–S38. doi: 10.1097/GIM.0b013e3181d5a67b

TABLE 4.

COST EFFECTIVENESS STUDIES COMPARING PROPHYLACTIC SURGERY TO SURVEILLANCE ALONE

Study	Context	Results (Cost per QALY)
Grann (1998)¹⁰¹	Positive BRCA test in 30-year-old women at high-risk	Prophylactic Oophorectomy and Mastectomy = Dominated
Grann (1998)¹⁰¹	Positive BRCA test in 30-year-old women at high-risk	Prophylactic Oophorectomy = $5,600
Tengs (2000)¹⁰²	High-risk 30-year-old women assuming varying risks of mutation	BRCA testing then oophorectomy if positive by mutation probability:
		High Risk
		BRCA1 (p=0.5) and BRCA2 (p=0.0) = $3,900
		BRCA1 (p=0.25) and BRCA2 (p=25) = $4,700
		BRCA1 (p=0.0) and BRCA2 (p=0.5) = $5,400
		Moderate Risk
		BRCA1 (p=0.1) and BRCA2 (p=0.1) = $17,000
		Slight Risk
		BRCA1 (p=0.05) and BRCA2 (p=0.05) = $42,000
		Average Risk
		BRCA1 (p=0.0006) and BRCA2 (p=0.0002) = $1,600,000

Notes: “QALY” = Quality Adjusted Life Year. “Dominated” means that prophylactic mastectomy and oophorectomy in the Grann article actually saved money compared to surveillance alone.