乳腺癌患者生殖线BRCA测试的价值:使用已发表的价值框架进行成本效益分析的批判性审查
Lucille A Sun1, Qixin Li2, Amy Tung1
1Curta, Seattle, WA, USA.
Journal of medical economics
|December 7, 2025
概括
乳腺癌患者的早期生殖线BRCA (gBRCA) 检测对于治疗和手术决定至关重要. 然而,经济分析往往忽略了关键的价值元素和早期与晚期测试的好处.
科学领域:
- 在瘤学瘤学.
- 医学经济学 医学经济学
- 基因检测 基因检测 基因检测
背景情况:
- 在HER2阴性早期乳腺癌中进行生殖线BRCA (gBRCA) 检测会影响手术选择,向治疗和家庭查.
- 早期gBRCA测试为患者管理和预防策略提供了关键信息.
研究的目的:
- 确定经济分析中关于乳腺癌gBRCA检测的证据缺口.
- 评估gBRCA测试现有的成本效益分析 (CEA) 的全面性.
主要方法:
- 针对MEDLINE的有针对性的文献审查确定了乳腺和卵巢癌 (2014-2024) 中gBRCA测试的CEAs.
- 研究与21个已识别的与遗传测试相关的价值元素进行了映射.
主要成果:
- 确定了26个CEA;大多数专注于降低风险的手术 (RRS) 或PARP抑制剂 (PARPi) 的使用,很少有人考虑这两种.
- 只有15个CEA包括级联测试,5个考虑了工作生产力,2个包括患者成本.
- 大多数研究 (14/19) 发现gBRCA测试与没有测试相比具有成本效益.
结论:
- 现有的CEA缺乏对早期gBRCA测试影响的全面建模,包括RRS,PARPi使用和更广泛的价值元素.
- 需要进一步的研究,以充分评估早期gBRCA测试策略的价值.
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