Cost-effectiveness analysis of breast cancer multi-gene panel sequencing
10.3969/j.issn.1674-2982.2017.11.010
- VernacularTitle:乳腺癌多基因面板测序的成本效果分析
- Author:
yan Chun DU
1
Author Information
1. 澳门大学中华医药研究院 澳门 999078
- Keywords:
Breast cancer;
Cost-effectiveness analysis;
Decision-analytic model;
Next-generation sequencing panel
- From:
Chinese Journal of Health Policy
2017;10(11):59-66
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To model and evaluate the cost-effectiveness of next-generation sequencing(NGS)panel for the screening of breast and ovarian cancer using the decision-making model amongst UK Ashkenazi Jews(AJ) women in the German community,determining whether a multi-gene panel would be cost-effective in patients referred to high-risk of breast cancer when compared with no testing program.Methods:Based on the population epidemiology and cost data in the United Kingdom,a decision-analytic model was developed to compare lifetime costs and benefits associated with NGS panel.The cost-effectiveness analysis was analyzed from a payer,s perspective across a lifetime horizon.Multiple source data were used for estimating cancer incidence,total costs,life-years,quality-adjusted life-years(QALYs)and incremental cost-effectiveness ratio(ICER).Costs were reported at 2014 prices and discounted at 3.5%.Deterministic and probabilistic sensitivity analysis(PSA)based on Monte Carlo Simulations were per-formed to evaluate the robustness of model.Results:In the base-case analysis,compared with no screening strategy, multi-gene panel test lowered the cancer incidence by 1.1%(0.75% for breast cancer,0.47% for ovarian canc-er),and gained an additional 0.87 life years and 0.89 QALYs,resulting in a discounted ICER of? 6766/QALY. Considering 70%testing uptake,this led to 601 fewer breast cancer cases and 283 fewer ovarian cancer cases.One-way sensitivity analysis indicated that the model was robust to variations for most of model parameters.The penetrance rate of breast cancer susceptibility genes was an important factor affecting overall results of the model.PSA showed that the probability for NGS panel being cost-effective at the threshold of? 20000/QALY-￡ 30000/QALY was over than 90%,compared with no screening strategy.Conclusion: NGS panel testing of breast cancer was cost-effective compared with no screening strategy,especially for those AJ women with high mutation rates.
