HEALTH ECONOMIC EVALUATION OF PROSTATE CANCER RISK CONTROL USING PREIMPLANTATION GENETIC TESTING (PGT-M) FOR BRCA1/2 PATHOLOGICAL VARIANT CARRIERS
Author(s)
Seiya Taniguchi, MS1, Ryutaro Sakai, MS1, Mana AKAI, MS1, Saki Ozeki, MS1, Kensuke Moriwaki, BS, MS, PhD2, Tsuguo Iwatani, MD, PhD3, Nao Suzuki, MD, PhD3.
1Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan University, Kyoto, Japan, 3St. Marianna University School of Medicine, Kanagawa, Japan.
1Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan University, Kyoto, Japan, 3St. Marianna University School of Medicine, Kanagawa, Japan.
OBJECTIVES: BRCA1/2 pathogenic variants are associated with an increased risk of prostate cancer. Preimplantation genetic testing for monogenic disorders (PGT-M) is used to prevent transmission of these variants; however, economic evaluations in Japan are limited. This study aimed to evaluate the cost-effectiveness of PGT-M compared with natural conception from the perspective of the Japanese public healthcare payer.
METHODS: A combined decision tree and Markov model was developed to compare PGT-M and natural conception. Prostate cancer incidence and mortality were based on Japanese epidemiological data, and the increased risk associated with BRCA1/2 variants was modeled using published odds ratios. Costs were estimated using a claims database, and PGT-M cost and success rate were obtained from previous studies. A lifetime horizon and 2% annual discount rate were applied. The incremental cost-effectiveness ratio (ICER) was calculated, and sensitivity analyses were conducted.
RESULTS: In a scenario assuming a 100% success rate of PGT-M and considering only BRCA-related cancers, the ICER was approximately JPY 490 million/QALY for BRCA1 carriers and JPY 7.6 million/QALY for BRCA2 carriers. In contrast, under more clinically relevant conditions, the ICERs were approximately JPY 770 million/QALY and JPY 9.9 million/QALY, respectively. Sensitivity analyses indicated that the discount rate and success rate of PGT-M had substantial impacts on the ICER.
CONCLUSIONS: Although results varied depending on assumptions regarding success rate and cancer scope, the cost-effectiveness of PGT-M for prostate cancer risk reduction remained limited under the Japanese willingness-to-pay threshold of JPY 5 million/QALY.
METHODS: A combined decision tree and Markov model was developed to compare PGT-M and natural conception. Prostate cancer incidence and mortality were based on Japanese epidemiological data, and the increased risk associated with BRCA1/2 variants was modeled using published odds ratios. Costs were estimated using a claims database, and PGT-M cost and success rate were obtained from previous studies. A lifetime horizon and 2% annual discount rate were applied. The incremental cost-effectiveness ratio (ICER) was calculated, and sensitivity analyses were conducted.
RESULTS: In a scenario assuming a 100% success rate of PGT-M and considering only BRCA-related cancers, the ICER was approximately JPY 490 million/QALY for BRCA1 carriers and JPY 7.6 million/QALY for BRCA2 carriers. In contrast, under more clinically relevant conditions, the ICERs were approximately JPY 770 million/QALY and JPY 9.9 million/QALY, respectively. Sensitivity analyses indicated that the discount rate and success rate of PGT-M had substantial impacts on the ICER.
CONCLUSIONS: Although results varied depending on assumptions regarding success rate and cancer scope, the cost-effectiveness of PGT-M for prostate cancer risk reduction remained limited under the Japanese willingness-to-pay threshold of JPY 5 million/QALY.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE59
Topic
Economic Evaluation
Disease
SDC: Oncology