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A cost analysis of a cancer genetic service model in the UK

By Ingrid Slade, Helen Hanson, Angela George, Kelly Kohut, Ann Strydom, Sarah Wordsworth, Nazneen Rahman, MCG Programme

Posted 18 Sep 2015
bioRxiv DOI: 10.1101/027185 (published DOI: 10.1007/s12687-016-0266-4)

Background: Technological advances in DNA sequencing have made gene testing fast and more affordable. Evidence of cost-effectiveness of genetic service models is essential for successful translation, but remain sparse in the literature. In particular there is a lack of cost data related to genetic services. Methods: A detailed micro-costing of 28 pathways relating to breast and/or ovarian cancer and gene testing for the BRCA1 and BRCA2 genes (termed ′BRCA testing′) was carried out. These data were combined with patient-level data from a Royal Marsden Cancer Genetics Service audit during which BRCA testing was offered to individuals at ≥10% risk of having a mutation. Results: The average cost across all pathways was &pound2,222.68 (range &pound376.47- &pound13,531.24). The average pathway cost for a person with cancer was &pound1897.71 compared to &pound2,403.22 for a person without cancer. Of the women seen during audit period, 38% were affected with breast and/or ovarian cancer and 62% were unaffected but concerned about their family history. Conclusion: There is considerable variation in the costs of different gene testing pathways. Improved cost-efficiency could be achieved by increasing the proportion of cancer patients tested, because the pathway cost of an unaffected individual in whom testing has already been performed in a relative with cancer is considerably less.

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