Table A3.

Costs of Telephone Versus In-Person Genetic Counseling and Testing per Positive Mutation Detected Under Varying Assumptions

		Average Cost per Positive BRCA1/2 Case Detected, Dollars
		Cost of In-Person Counseling	Cost of Telephone Counseling	Incremental Cost of Telephone Versus In-Person Counseling
Variable Names	Scenario	40,330	37,160	−3,170
One-way sensitivity analysis (one variable changed at a time)
Rate of mutation detection	5%, both arms	80,660	74,350	−6,310
	20%, both arms	20,160	18,580	−1,580
Type of test	Buccal swab (v blood draw)	40,050	36,970	−3,080
Test costs	Known mutation at $250	950	570	−380
Health care system perspective	Omits patient time costs	38,820	36,350	−2,470
Economy of scale	Increase the number counseled per trip from three to six in in-person arm	38,950	37,150	−1,800
Travel time	Decrease counselor travel distance to provide services by 50%	39,200	37,150	−2,050
Multiway sensitivity analysis
Range of values most favorable to in-person	Highest telephone costs and lowest in-person costs Mutation test price $400 in both arms; in-person counseling yields	38,870	38,770	−100
Combination of conditions most favorable to in-person	20% mutation positivity and six women are counseled per trip versus 10% positivity in telephone arm	4,780	7,260	2,480

NOTE. Negative numbers favor telephone counseling.