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

Abstract

BackgroundTechnological 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.\n\nMethodsA 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.\n\nResultsThe average cost across all pathways was {pound}2,222.68 (range {pound}376.47-{pound}13,531.24). The average pathway cost for a person with cancer was {pound}1897.71 compared to {pound}2,403.22 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.\n\nConclusionThere 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.\n\nAcknowledgementsWe acknowledge NHS funding to the Royal Marsden/ICR NIHR Specialist Biomedical Research Centre for Cancer. SW is supported by funding through the NIHR Oxford Biomedical Research Centre. This work was supported by Wellcome Trust Award 098518/Z/12/Z. For MCG programme see www.mcgprogramme.com.\n\nConflict of Interest StatementThere are no conflicts of interests for any author of this paper