Table 2.
Lifetime discounted costs and effects per woman and ICER after genetic testing for all patients with BC a.
| Testing all BC Patients | No Testing | ICER | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Effects | Costs (USD) | Health Effects | Costs (USD) | Cost/LYG | Cost/QALY | ||||||
| LYGs | QALYs | Payer | Societal | LYGs | QALYs | Payer | Societal | Payer | Societal | Payer | Societal |
| Baseline | |||||||||||
| 14.164 | 13.483 | 4686 | 6808 | 14.144 | 13.465 | 4554 | 6726 | 6509 | 4037 | 7266 | 4506 |
| Scenario: No reduction in BC risk from RRSO b | |||||||||||
| 14.164 | 13.483 | 4686 | 6808 | 14.144 | 13.465 | 4554 | 6726 | 6508 | 4060 | 7308 | 4558 |
| Scenario: No HRT Adherence c | |||||||||||
| 14.163 | 13.483 | 4687 | 6809 | 14.144 | 13.465 | 4554 | 6726 | 6730 | 4201 | 7576 | 4729 |
| Scenario: Half RRM uptake in unaffected relatives d | |||||||||||
| 14.164 | 13.483 | 4687 | 6811 | 14.144 | 13.465 | 4554 | 6726 | 6546 | 4198 | 7449 | 4777 |
| Scenario: Half RRSO uptake in unaffected relatives e | |||||||||||
| 14.163 | 13.482 | 4682 | 6807 | 14.144 | 13.465 | 4554 | 6726 | 6425 | 4090 | 7439 | 4735 |
| Scenario: Half RRM and half RRSO uptake in unaffected relatives f | |||||||||||
| 14.164 | 13.482 | 4685 | 6813 | 14.144 | 13.465 | 4554 | 6726 | 6514 | 4342 | 7802 | 5201 |
| Scenario: Half CPM uptake in patients g | |||||||||||
| 14.160 | 13.481 | 4683 | 6812 | 14.144 | 13.465 | 4554 | 6726 | 7857 | 5243 | 8310 | 5546 |
| Scenario: Half RRSO uptake in patients h | |||||||||||
| 14.160 | 13.481 | 4672 | 6800 | 14.144 | 13.465 | 4554 | 6726 | 7014 | 4412 | 7588 | 4773 |
| Scenario: Lower uptake rate of genetic testing in patients and relatives i (70%) | |||||||||||
| 14.158 | 13.477 | 4644 | 6787 | 14.144 | 13.465 | 4554 | 6726 | 6229 | 4233 | 7575 | 5148 |
| Scenario: Lower uptake rate of genetic testing in patients and relatives i (50%) | |||||||||||
| 14.153 | 13.473 | 4607 | 6762 | 14.144 | 13.465 | 4554 | 6726 | 5449 | 3731 | 6922 | 4739 |
| Scenario: No VUS management j | |||||||||||
| 14.162 | 13.479 | 4629 | 6766 | 14.144 | 13.465 | 4554 | 6726 | 3943 | 2097 | 5355 | 2848 |
Abbreviations: BC, breast cancer; HRT, hormone replacement therapy; ICER, incremental cost-effectiveness ratio, LYG, life-years gained; QALY, quality-adjusted life-year; RRM, risk-reducing mastectomy; RRSO, risk-reducing salpingo-oophorectomy. a Discounted at 3%; b Probability P15 = 1 (Table S1 in the Supplement); c Probability P21 = 0 (Table S1 in the Supplement); d Probability P9 = 0.235 (Table S1 in the Supplement); e Probability P11 = 0.275 (Table S1 in the Supplement); e Probability P9 = 0.235 and Probability P11 = 0.275 (Table S1 in the Supplement); g Probability P10 = 0.270 (Table S1 in the Supplement); h Probability P12 = 0.284 (Table S1 in the Supplement); i (70%) Indicates a genetic testing uptake rate of 70%; i (50%) Indicates a genetic testing uptake rate of 50%; j Indicates no VUS management.