HEALTH ECONOMIC EVALUATION OF PANCREATIC CANCER RISK CONTROL USING PREIMPLANTATION GENETIC TESTING FOR MONOGENIC DISORDERS (PGT-M) IN BRCA1/2 PATHOGENIC VARIANT CARRIERS
Author(s)
Ryutaro Sakai1, Mana AKAI, MS2, Saki Ozeki, MS3, Seiya Taniguchi, MS2, Kensuke Moriwaki, BS, MS, PhD4, Tsuguo Iwatani, MD, PhD5, Nao Suzuki, MD, PhD5.
1Student, Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan University, Kusatsu, Japan, 3Ritsumeikan university, Kusatsu, Japan, 4Ritsumeikan University, Kyoto, Japan, 5St. Marianna University School of Medicine, Kawasaki, Japan.
1Student, Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan University, Kusatsu, Japan, 3Ritsumeikan university, Kusatsu, Japan, 4Ritsumeikan University, Kyoto, Japan, 5St. Marianna University School of Medicine, Kawasaki, Japan.
OBJECTIVES: Pathogenic variants in BRCA1/2 are associated with an increased risk of pancreatic cancer. Preimplantation genetic testing for monogenic disorders (PGT-M) is used to prevent the transmission of these variants. However, economic evaluations in Japan remain 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 with natural conception. The incidence and mortality of pancreatic cancer 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, while the cost and success rate of PGT-M were obtained from previous studies. A lifetime horizon and an annual discount rate of 2% were applied. The incremental cost-effectiveness ratio (ICER) was calculated, and sensitivity analyses were conducted.
RESULTS: Assuming a 100% success rate for PGT-M and considering only BRCA-related cancer, the ICER was JPY 2,806,809/QALY for BRCA1 carriers and JPY 3,742,270/QALY for BRCA2 carriers. In contrast, under more clinically relevant assumptions, ICER were JPY 4,826,869/QALY and JPY 6,514,946/QALY, respectively. Sensitivity analysis showed that the discount rate and success rate of PGT-M had substantial effects on the ICER.
CONCLUSIONS: Compared with natural conception, PGT-M for both BRCA1 and BRCA2 carriers was suggested to have ICER that were generally within or close to the acceptable range, although some scenarios exceeded the willingness-to-pay threshold. However, the evaluation results were highly dependent on the assumptions regarding the discount rate and the success rate of PGT-M, indicating substantial uncertainty in the estimated ICER.
METHODS: A combined decision tree and Markov model was developed to compare PGT-M with natural conception. The incidence and mortality of pancreatic cancer 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, while the cost and success rate of PGT-M were obtained from previous studies. A lifetime horizon and an annual discount rate of 2% were applied. The incremental cost-effectiveness ratio (ICER) was calculated, and sensitivity analyses were conducted.
RESULTS: Assuming a 100% success rate for PGT-M and considering only BRCA-related cancer, the ICER was JPY 2,806,809/QALY for BRCA1 carriers and JPY 3,742,270/QALY for BRCA2 carriers. In contrast, under more clinically relevant assumptions, ICER were JPY 4,826,869/QALY and JPY 6,514,946/QALY, respectively. Sensitivity analysis showed that the discount rate and success rate of PGT-M had substantial effects on the ICER.
CONCLUSIONS: Compared with natural conception, PGT-M for both BRCA1 and BRCA2 carriers was suggested to have ICER that were generally within or close to the acceptable range, although some scenarios exceeded the willingness-to-pay threshold. However, the evaluation results were highly dependent on the assumptions regarding the discount rate and the success rate of PGT-M, indicating substantial uncertainty in the estimated ICER.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HTA34
Topic
Health Technology Assessment
Disease
SDC: Oncology