Cost effectiveness of the cancer prevention program for carriers of the BRCA1/2 mutation

Autores

  • Marcelo Cristiano de Azevedo Ramos Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Instituto Central
  • Maria Aparecida Azevedo Koike Folgueira Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Instituto do Câncer do Estado de São Paulo. Centro de Investigação Translacional em Oncologia
  • Simone Maistro Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Instituto do Câncer do Estado de São Paulo. Centro de Investigação Translacional em Oncologia
  • Alessandro Gonçalves Campolina Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Instituto do Câncer do Estado de São Paulo. Centro de Investigação Translacional em Oncologia
  • Patricia Coelho de Soárez Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva
  • Geertruida Hendrika de Bock University of Groningen. University Medical Center Groningen. Department of Epidemiology
  • Hillegonda Maria Dutilh Novaes Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva
  • Maria Del Pilar Estevez Diz Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Instituto do Câncer do Estado de São Paulo. Divisão de Oncologia Clínica

DOI:

https://doi.org/10.11606/S1518-8787.2018052000643

Palavras-chave:

Ovarian Neoplasms, diagnosis, Genes, BRCA1, Genes, BRCA2, Early Detection of Cancer, economics, Cost-Effectiveness Evaluation

Resumo

OBJECTIVE: To analyze the cost effectiveness of the diagnostic program for the germline mutation in BRCA1/2 genes and of preventative strategies for the relatives of patients diagnosed with ovarian cancer associated with this mutation. METHODS: The study analyzed the cost effectiveness by developing an analysis of the Markov decision process from the perspective of the National Health System. The strategies compared reflect upon the adoption of genetic testing and preventative strategies for relatives or the usual care currently proposed. The incremental cost-effectiveness ratio was expressed in terms of cost per case avoided. The sensitivity analysis was performed in a univariate and deterministic manner. RESULTS: The study showed increments for effectiveness and for costs when performing genetic testing and adopting prophylactic measures for family members. The incremental cost-effectiveness ratio was estimated at R$908.58 per case of cancer avoided, a figure considered lower than the study’s cost-effectiveness threshold (R$7,543.50). CONCLUSIONS: The program analyzed should be considered a cost-effective strategy for the national situation. Studies in various other countries have reached similar conclusions. One possible ramification of this research might the need to perform a budgetary-impact analysis of making the program one of the country’s health policies

Publicado

2018-11-22

Edição

Seção

Artigos Originais

Como Citar

Ramos, M. C. de A., Folgueira, M. A. A. K., Maistro, S., Campolina, A. G., Soárez, P. C. de, Bock, G. H. de, Novaes, H. M. D., & Diz, M. D. P. E. (2018). Cost effectiveness of the cancer prevention program for carriers of the BRCA1/2 mutation. Revista De Saúde Pública, 52, 94. https://doi.org/10.11606/S1518-8787.2018052000643