Cost comparison of genetic testing strategies in women with epithelial ovarian cancer

Published

Journal Article

Copyright © 2017 American Society of Clinical Oncology. All rights reserved. Purpose The advent of multigene panels has increased genetic testing options for women with epithelial ovarian cancer (EOC). We designed a decision model to compare costs and probabilities of identifying a deleterious mutation or variant of uncertain significance (VUS) using different genetic testing strategies. Methods A decision model was developed to compare costs and outcomes of two testing strategies for women with EOC: multigene testing (MGT) versus single-gene testing for BRCA1/2. Outcomes were mean cost and number of deleterious mutations and VUSs identified. Model inputs were obtained from published genetic testing data in EOC. One-way sensitivity analyses and Monte Carlo probabilistic sensitivity analyses were performed. Results No family history model: MGT cost $1,160 more on average than BRCA1/2 testing and identified an additional 3.8 deleterious mutations for every 100 women tested. For each additional deleterious mutation identified,MGTcost $30,812 and identified 5.4 additional VUSs. Family history model: MGT cost $654 more on average and identified an additional 7.0 deleterious mutations for every 100 women tested. For each additional deleterious mutation identified, MGT cost $9,909 and identified 2.6 additional VUSs. Conclusion MGTwas associated with a higher additional cost per deleterious mutation identified and a higher ratio of VUS burden to actionable information in women with no family history as compared with women with a family history. Family history should be considered when determining an initial genetic testing platform in women with EOC.

Full Text

Duke Authors

Cited Authors

  • Foote, JR; Lopez-Acevedo, M; Buchanan, AH; Secord, AA; Lee, PS; Fountain, C; Myers, ER; Cohn, DE; Reed, SD; Havrilesky, LJ

Published Date

  • February 1, 2017

Published In

Volume / Issue

  • 13 / 2

Start / End Page

  • e120 - e129

Electronic International Standard Serial Number (EISSN)

  • 1935-469X

International Standard Serial Number (ISSN)

  • 1554-7477

Digital Object Identifier (DOI)

  • 10.1200/JOP.2016.011866

Citation Source

  • Scopus