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논문 기본 정보

자료유형
학술저널
저자정보
Jang Jaehyeok (Department of Laboratory Medicine Yonsei University College of Medicine Seoul Korea) Kim Yoonjung (Department of Laboratory Medicine Yonsei University College of Medicine Seoul Korea) Kim Jae-Hoon (Department of Obstetrics and Gynecology Gangnam Severance Hospital Seoul Korea) Cho Sun-Mi (Department of Laboratory Medicine CHA Bundang Medical Center CHA University Seongnam Korea) Lee Kyung-A (Department of Laboratory Medicine Yonsei University College of Medicine Seoul Korea)
저널정보
대한진단검사의학회 Annals of Laboratory Medicine Annals of Laboratory Medicine 제43권 제1호
발행연도
2023.1
수록면
73 - 81 (9page)
DOI
10.3343/alm.2023.43.1.73

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Background: BRCA testing is necessary for establishing a management strategy for ovarian cancer. Several BRCA testing strategies, including germline and somatic testing, are implemented in clinical practice in Korea. We aimed to comparatively evaluate their cost-effectiveness from patients’ perspective. Methods: We developed a decision model comprising five BRCA testing strategies implemented in Korea: (1) germline testing first, followed by somatic tumor testing for patients without a germline variant; (2) somatic testing first, followed by germline testing for patients with a variant detected by somatic testing; (3) both germline and somatic testing; (4) germline testing alone; and (5) somatic testing alone, with no testing as the comparator. One-way sensitivity analysis was conducted to test the uncertainty of key parameters. Results: Assuming a willingness-to-pay of $20,000 per progression-free life-year gain (PF-LYG), all five strategies were considered cost-effective. Strategy 4 was the most cost-effective option, with an incremental cost-effectiveness ratio (ICER) of $2,547.7 per PF-LYG, followed by strategy 1, with an ICER of $3,978.4 per PF-LYG. Even when the parameter values were varied within the possible range, the ICERs of all strategies did not exceed the willingness-to-pay threshold. Conclusions: Considering the importance of knowing a patient’s BRCA gene status, germline testing first, followed by somatic testing, may be a reasonable option.

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