Author (Year) | Source of cost data | International value of genetic testing (2022) USD | Source of effectiveness data | Willingness to pay threshold USD | Outcome measurement | Cost-effectiveness results, ICER* and conclusion from study |
---|---|---|---|---|---|---|
Genetic testing for breast cancer only | ||||||
Lim et al. (2018) [30] | Local Hospital | 451.5 (2016) → 509.31 (2022) | Literature Search from Other Countries | 9500 USD/QALY (1 time GDP per capita) | Incremental Costs per QALY (ICERs), Incremental Costs per LYS (ICERs) | • ICER: USD 2566/QALY; USD 918/life-year saved • Genetic testing is cost-effective compared to routine clinical surveillance as it was below WTP threshold. |
Sun et al. (2022) [32] | Sampling database of the Chinese Urban Basic Medical Insurance | 367 (2019) → 390.36 (2022) | Lifetime Tables from each country were obtained from the World Health Organization (WHO) and published literatures. | 10,262 USD/QALY (1 time GDP per capita) | Incremental Costs per QALY (ICERs), Incremental Costs per LYG (ICERs) | • Multigene testing for all BC patients VS No genetic testing USD 4793/QALY, USD 4294/LYG (Societal) & USD 7729/QALY, USD 6923/LYG (payer perspective) • Unselected multigene testing to all BC patients in China is cost-effective as compared with no testing or selected testing as it was below WTP threshold |
Wu et al. (2023) [29] | Price Announcement by the Shanghai Health Minister of China | 308.6 (2021) → 314.98 (2022) | Published literatures | 31,500 USD /QALY | Primary Outcome: QALY gained & ICERs Secondary Outcome: life expectancy gained & survival outcome | • Universal gBRCA testing among TNBC patient compared with no testing and selected testing respectively, ICERs of USD 10,812/QALY and USD 11,218 /QALY • Universal testing for all HER2-negative BC patients compared with no testing and selected testing respectively, with ICERs of USD 2214/QALY & USD 2065/QALY. • Universal gBRCA testing is cost-effective as the ICER value is below the WTP threshold. |
Genetic Testing for Breast Cancer and Ovarian Cancer | ||||||
Manchanda et al. (2020) [31] | China Urban Basic Medical Insurance Database; Brazil Management System of Procedures/Medical drugs/Orthotics/Prosthetics/Special Materials (SIGTAP), the Health Price Bank (BPS), and Chamber of Regulation of the Market of Medicines (CMED); India Accredited Cancer Centre Tata Medical Centre | 200 (2016) → 225.61 (2022) | Lifetime Tables from each country were obtained from the World Health Organization (WHO); QALY values obtained from published literatures. | China: ($15,531/QALY-$46,592/QALY) Brazil: ($15,182/QALY-$45,545/QALY India: ($6574/QALY-$19,722/QALY) WTP were based on 1–3 times GDP of each country | Lifetime costs and QALYs, ICERs | • ICER China Societal: USD 26,716/LY, USD 20,379/QALY Payer: USD 34,730/LY, USD 26,492/QALY Brazil Societal: USD 17,873/LY, USD 15,318/QALY Payer: USD 27,632/LY, USD 23,683/QALY India Societal: USD 31,831/LY, USD 25,980/QALY Payer: USD 44,527/LY, USD 36,342/QALY • BRCA testing is cost-effective in both China and Brazil except India from both payer and societal perspective when compared to the WTP threshold set in the study |
Simoes Correa-Galendi et al. (2021) [33] | Official Brazilian Universal Health Coverage System (SUS) database and local distributors | 1480 (2019) → 1574.22 (2022) | Several systematic literature searches in Medline and BIREME (a Latin American health database) | Not well defined | Incremental Costs per QALY (ICERs), Incremental Costs per LYG (ICERs) | • ICER: USD 12,472/QALY & USD 14,013/ LYG • Cost-effectiveness of BRCA testing is still depends on undecided cost-effectiveness threshold. The ICER is 1.04 times the GDP per capita |
Lourencao et al. (2022) [34] | Official Brazilian Universal Health Coverage System (SUS) database | 524.98 (2021)→ 535.84 (2022) | Published studies from a systematic literature search in the PubMed database | R$ 25,000/QALY (U$ 11, 563.37/QALY) Based on the lowest thresholds reported in National Commission for the Incorporation of Technologies (CONITEC) | Incremental Costs per QALY (ICERs), Incremental Costs per LYG (ICERs) | • ICER: USD 5618/QALY and USD 5188/ LYG • BRCA testing is cost-effective if the WTP is USD 11,563.37/QALY |