Estimating Costs Avoided by Preventing Recurrences With a BRCA Testing Strategy in High-Risk HER2-Negative Adjuvant Breast Cancer Patients in Spain
Author(s)
Ana M. Santaballa, Dr1, Laura Lema, Dr2, Yolanda Fernández, Dr3, Elena Vicente Rubio, Dr4, Isabel Angulo, MSc5, Laura De Santiago, MSc5, Raquel Esteve, MSc5, Sandra Garde, MSc6, Maria Giovanna Ferrario, MSc6, Sergio Cedillo, MSc5.
1Hospital Universitario Politécnico de la Fe, Valencia, Spain, 2Hospital Universitario 12 de Octubre, Madrid, Spain, 3Hospital Universitario Central de Asturias, Oviedo, Spain, 4Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain, 5AstraZeneca, Madrid, Spain, 6Evidenze Health, Madrid, Spain.
1Hospital Universitario Politécnico de la Fe, Valencia, Spain, 2Hospital Universitario 12 de Octubre, Madrid, Spain, 3Hospital Universitario Central de Asturias, Oviedo, Spain, 4Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain, 5AstraZeneca, Madrid, Spain, 6Evidenze Health, Madrid, Spain.
OBJECTIVES: This study aimed to estimate the clinical benefit, in terms of avoided cancer recurrences, of performing BRCA mutation (BRCAm) testing at the time of adjuvant therapy selection in high-risk HER2-negative breast cancer patients in Spain, followed by olaparib treatment for BRCAm-positive patients, versus a scenario without BRCA testing. Additionally, the study quantified the direct and indirect costs associated with these recurrences.
METHODS: A health economic model was developed based on the annual incidence of breast cancer in Spain (37,682), 90% of the new cases were detected in early stage. Two treatment strategies for high-risk patients were compared: (1) a strategy without BRCA testing, where high-risk HER2-negative, hormone receptor-positive (HR+) patients receive abemaciclib and triple-negative breast cancer (TNBC) patients receive pembrolizumab as adjuvant therapies; and (2) a strategy including BRCA testing, in which identified BRCAm-positive patients receive adjuvant olaparib and non-BRCAm positive patients received abemaciclib or pembrolizumab. The difference in the number of recurrences between these strategies was calculated, along with the associated savings in terms of direct and indirect costs for the Spanish National Health System (NHS) and society. All the analysis were conducted using list prices.
RESULTS: Implementing BRCA testing and treating BRCAm-positive patients with olaparib prevented a total of 72 recurrences compared to a scenario of notperforming BRCA testing. These avoided recurrences translate to an estimated total cost saving of €12 million for the Spanish NHS.
CONCLUSIONS: BRCA testing before adjuvant treatment selection is an efficient strategy that not only reduces the risk of disease recurrence in high-risk patients, but also provides considerable cost savings for the NHS and society.
METHODS: A health economic model was developed based on the annual incidence of breast cancer in Spain (37,682), 90% of the new cases were detected in early stage. Two treatment strategies for high-risk patients were compared: (1) a strategy without BRCA testing, where high-risk HER2-negative, hormone receptor-positive (HR+) patients receive abemaciclib and triple-negative breast cancer (TNBC) patients receive pembrolizumab as adjuvant therapies; and (2) a strategy including BRCA testing, in which identified BRCAm-positive patients receive adjuvant olaparib and non-BRCAm positive patients received abemaciclib or pembrolizumab. The difference in the number of recurrences between these strategies was calculated, along with the associated savings in terms of direct and indirect costs for the Spanish National Health System (NHS) and society. All the analysis were conducted using list prices.
RESULTS: Implementing BRCA testing and treating BRCAm-positive patients with olaparib prevented a total of 72 recurrences compared to a scenario of notperforming BRCA testing. These avoided recurrences translate to an estimated total cost saving of €12 million for the Spanish NHS.
CONCLUSIONS: BRCA testing before adjuvant treatment selection is an efficient strategy that not only reduces the risk of disease recurrence in high-risk patients, but also provides considerable cost savings for the NHS and society.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE418
Topic
Economic Evaluation, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology