IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v23y2022i5d10.1007_s10198-021-01396-9.html
   My bibliography  Save this article

Cost–utility analysis of risk-reducing strategies to prevent breast and ovarian cancer in BRCA-mutation carriers in Switzerland

Author

Listed:
  • Claudine Bommer

    (University of Zurich
    University Hospital Basel)

  • Judith Lupatsch

    (University of Basel)

  • Nicole Bürki

    (University Hospital Basel)

  • Matthias Schwenkglenks

    (University of Basel)

Abstract

Objective We aimed to identify the most cost-effective of all prophylactic measures available in Switzerland for women not yet affected by breast and ovarian cancer who tested positive for a BRCA1/2 mutation. Methods Prophylactic bilateral mastectomy (PBM), salpingo-oophorectomy (PBSO), combined PBM&PBSO and chemoprevention (CP) initiated at age 40 years were compared with intensified surveillance (IS). A Markov model with a life-long time horizon was developed from the perspective of the Swiss healthcare system using mainly literature-derived data to evaluate costs, quality-adjusted life years (QALYs) and survival. Costs and QALYs were discounted by 3% per year. Robustness of the results was tested with deterministic and probabilistic sensitivity analyses. Results All prophylactic measures were found to be cost-saving with an increase in QALYs and life years (LYs) compared to IS. PBM&PBSO were found to be most cost-effective and dominated all other strategies in women with a BRCA1 or BRCA2 mutation. Lifetime costs averaged to 141,293 EUR and 14.5 QALYs per woman with a BRCA1 mutation under IS, versus 76,639 EUR and 19.2 QALYs for PBM&PBSO. Corresponding results for IS per woman with a BRCA2 mutation were 102,245 EUR and 15.5 QALYs, versus 60,770 EUR and 19.9 QALYs for PBM&PBSO. The results were found to be robust in sensitivity analysis; no change in the dominant strategy for either BRCA-mutation was observed. Conclusion All more invasive strategies were found to increase life expectancy and quality of life of women with a BRCA1 or BRCA2 mutation and were cost-saving for the Swiss healthcare system compared to IS.

Suggested Citation

  • Claudine Bommer & Judith Lupatsch & Nicole Bürki & Matthias Schwenkglenks, 2022. "Cost–utility analysis of risk-reducing strategies to prevent breast and ovarian cancer in BRCA-mutation carriers in Switzerland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(5), pages 807-821, July.
    • Handle: RePEc:spr:eujhec:v:23:y:2022:i:5:d:10.1007_s10198-021-01396-9
    DOI: 10.1007/s10198-021-01396-9
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10198-021-01396-9
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s10198-021-01396-9?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Patrick W. Sullivan & Vahram Ghushchyan, 2006. "Preference-Based EQ-5D Index Scores for Chronic Conditions in the United States," Medical Decision Making, , vol. 26(4), pages 410-420, July.
    2. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March.
    3. Rob Anderson, 2010. "Systematic reviews of economic evaluations: utility or futility?," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 350-364, March.
    4. Dirk Müller & Marion Danner & Kerstin Rhiem & Björn Stollenwerk & Christoph Engel & Linda Rasche & Lisa Borsi & Rita Schmutzler & Stephanie Stock, 2018. "Cost-effectiveness of different strategies to prevent breast and ovarian cancer in German women with a BRCA 1 or 2 mutation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(3), pages 341-353, April.
    5. Peasgood, T & Ward, S & Brazier, J, 2010. "A review and meta-analysis of health state utility values in breast cancer," MPRA Paper 29950, University Library of Munich, Germany.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bromley, Hannah L. & Petrie, Dennis & Mann, G.Bruce & Nickson, Carolyn & Rea, Daniel & Roberts, Tracy E., 2019. "Valuing the health states associated with breast cancer screening programmes: A systematic review of economic measures," Social Science & Medicine, Elsevier, vol. 228(C), pages 142-154.
    2. Christine McDonough & Anna Tosteson, 2007. "Measuring Preferences for Cost-Utility Analysis," PharmacoEconomics, Springer, vol. 25(2), pages 93-106, February.
    3. Kristina Burström & Magnus Johannesson & Finn Diderichsen, 2003. "The value of the change in health in Sweden 1980/81 to 1996/97," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 637-654, August.
    4. Hougaard, Jens Leth & Moreno-Ternero, Juan D. & Østerdal, Lars Peter, 2013. "A new axiomatic approach to the evaluation of population health," Journal of Health Economics, Elsevier, vol. 32(3), pages 515-523.
    5. McCabe, Christopher & Brazier, John & Gilks, Peter & Tsuchiya, Aki & Roberts, Jennifer & O'Hagan, Anthony & Stevens, Katherine, 2006. "Using rank data to estimate health state utility models," Journal of Health Economics, Elsevier, vol. 25(3), pages 418-431, May.
    6. David Mayston, "undated". "Developing a Framework Theory for Assessing the Benefits of Careers Guidance," Discussion Papers 02/08, Department of Economics, University of York.
    7. Sanjib Saha & Ulf-G Gerdtham & Pia Johansson, 2010. "Economic Evaluation of Lifestyle Interventions for Preventing Diabetes and Cardiovascular Diseases," IJERPH, MDPI, vol. 7(8), pages 1-46, August.
    8. Richard D. Smith, 2008. "Contingent valuation in health care: does it matter how the ‘good’ is described?," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 607-617, May.
    9. Islam, M. Kamrul & Gerdtham, Ulf-G. & Gullberg, Bo & Lindström, Martin & Merlo, Juan, 2008. "Social capital externalities and mortality in Sweden," Economics & Human Biology, Elsevier, vol. 6(1), pages 19-42, March.
    10. Knott, R. & Lorgelly, P. & Black, N. & Hollingsworth, B., 2016. "Differential item functioning in the EQ-5D: An exploratory analysis using anchoring vignettes," Health, Econometrics and Data Group (HEDG) Working Papers 16/14, HEDG, c/o Department of Economics, University of York.
    11. Micah Rose & Stephen Rice & Dawn Craig, 2018. "Does Methodological Guidance Produce Consistency? A Review of Methodological Consistency in Breast Cancer Utility Value Measurement in NICE Single Technology Appraisals," PharmacoEconomics - Open, Springer, vol. 2(2), pages 97-107, June.
    12. Mark Sculpher & Amiram Gafni, 2001. "Recognizing diversity in public preferences: The use of preference sub‐groups in cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 317-324, June.
    13. Cookson, Richard, 2000. "Incorporating psycho-social considerations into health valuation: an experimental study," Journal of Health Economics, Elsevier, vol. 19(3), pages 369-401, May.
    14. Han Bleichrodt, 2002. "A new explanation for the difference between time trade‐off utilities and standard gamble utilities," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 447-456, July.
    15. Hammer, Jeffrey S., 1992. "To prescribe or not to prescribe: On the regulation of pharmaceuticals in less developed countries," Social Science & Medicine, Elsevier, vol. 34(9), pages 959-964, May.
    16. Garattini, Livio & van de Vooren, Katelijne & Curto, Alessandro, 2015. "Cost-effectiveness of trastuzumab in metastatic breast cancer: Mainly a matter of price in the EU?," Health Policy, Elsevier, vol. 119(2), pages 212-216.
    17. Alejandro Arrieta & Timothy F Page & Emir Veledar & Khurram Nasir, 2017. "Economic Evaluation of PCSK9 Inhibitors in Reducing Cardiovascular Risk from Health System and Private Payer Perspectives," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-14, January.
    18. Smith, Richard D. & Richardson, Jeff, 2005. "Can we estimate the `social' value of a QALY?: Four core issues to resolve," Health Policy, Elsevier, vol. 74(1), pages 77-84, September.
    19. Thomas Hammerschmidt & Hans-Peter Zeitler & Markus Gulich & Reiner Leidl, 2004. "A Comparison of Different Strategies to Collect Standard Gamble Utilities," Medical Decision Making, , vol. 24(5), pages 493-503, October.
    20. Shan Liu & Michaël Schwarzinger & Fabrice Carrat & Jeremy D Goldhaber-Fiebert, 2011. "Cost Effectiveness of Fibrosis Assessment Prior to Treatment for Chronic Hepatitis C Patients," PLOS ONE, Public Library of Science, vol. 6(12), pages 1-14, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:23:y:2022:i:5:d:10.1007_s10198-021-01396-9. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.