Cost-effectiveness of BRCA1/2 mutation profiling to target olaparib use in patients with metastatic breast cancer

Per Med. 2019 Nov;16(6):439-448. doi: 10.2217/pme-2018-0141. Epub 2019 Nov 6.

Abstract

Aim: Olaparib monotherapy improves progression-free survival in patients with metastatic breast cancer and BRCA1/2 mutations. We evaluated the cost-effectiveness of BRCA1/2 mutation profiling to target olaparib use. Methods: A Markov cohort model was generated to compare the 5-year cost-effectiveness of BRCA1/2 mutation profiling to target olaparib use. Results: The incremental cost-effectiveness ratio of BRCA1/2 mutation profiling plus olaparib monotherapy was JPY14,677,259/quality-adjusted life year (QALY) (US$131,047/QALY), compared with standard chemotherapy alone. Conclusion:BRCA1/2 mutation profiling to target olaparib use is not a cost-effective strategy for metastatic breast cancer. The strategy provides minimal incremental benefit at a high incremental cost per QALY. Hence, further cost reductions in the cost of both BRCA1/2 mutation profiling and olaparib are required.

Keywords: BRCA1/2 mutation; Markov model; breast cancer; cost–effectiveness; olaparib.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • BRCA1 Protein / genetics
  • BRCA2 Protein / genetics
  • Breast Neoplasms / genetics
  • Cost-Benefit Analysis / economics*
  • Female
  • Genetic Testing / economics*
  • Humans
  • Markov Chains
  • Phthalazines / economics*
  • Phthalazines / therapeutic use
  • Piperazines / economics*
  • Piperazines / therapeutic use
  • Quality-Adjusted Life Years

Substances

  • BRCA1 Protein
  • BRCA1 protein, human
  • BRCA2 Protein
  • BRCA2 protein, human
  • Phthalazines
  • Piperazines
  • olaparib