Michael G Schrauder1, Lisa Brunel-Geuder2, Lothar Häberle2, Marius Wunderle2, Juliane Hoyer3, André Reis3, Rüdiger Schulz-Wendtland4, Matthias W Beckmann2, Michael P Lux2. 1. Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Obstetrics and Gynecology, Erlangen University Hospital, University Breast Center for Franconia, Erlangen, Germany. Electronic address: Michael.Schrauder@uk-erlangen.de. 2. Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Obstetrics and Gynecology, Erlangen University Hospital, University Breast Center for Franconia, Erlangen, Germany. 3. Friedrich-Alexander University Erlangen-Nürnberg (FAU), Institute of Human Genetics, University Breast Center for Franconia, Erlangen, Germany. 4. Friedrich-Alexander University Erlangen-Nürnberg (FAU), Institute of Radiology, Erlangen University Hospital, University Breast Center for Franconia, Erlangen, Germany.
Abstract
OBJECTIVES: Risk-reducing surgeries are a feasible option for mitigating the risk in individuals with inherited susceptibility to cancer, but are the procedures cost-effective in the current health-care system in Germany? This study compared the health-care costs for bilateral risk-reducing mastectomy (BRRM) and risk-reducing (bilateral) salpingo-oophorectomy (RRSO) with cancer treatment costs that could potentially be prevented. PATIENTS AND METHODS: The analysis is based on interdisciplinary consultations with individuals with a high familial risk for breast and ovarian cancer at the University Breast Center for Franconia (Germany) between 2009 and 2013 (370 consultations; 44 patients with BRCA1 mutations and 26 with BRCA2 mutations). Health-care costs for risk-reducing surgeries in BRCA mutation carriers were calculated as reimbursements in the German diagnosis-related groups (DRG) hospital pricing system. These costs for the health-care system were compared with the potential cancer treatment costs that could possibly be prevented by risk-reducing surgeries. RESULTS: Long-term health-care costs can be reduced by risk-reducing surgeries after genetic testing in BRCA mutation carriers. The health-care system in Germany would have saved € 136,295 if BRRM had been performed and € 791,653 if RRSO had been performed before the development of cancer in only 50% of the 70 mutation carriers seen in our center. Moreover, in patients with combined RRSO and BRRM (without breast reconstruction), one further life-year for a 40-year-old BRCA mutation carrier would cost € 2,183. CONCLUSION: Intensive care, including risk-reducing surgeries in BRCA mutation carriers, is cost-effective from the point of view of the health-care system in Germany.
OBJECTIVES: Risk-reducing surgeries are a feasible option for mitigating the risk in individuals with inherited susceptibility to cancer, but are the procedures cost-effective in the current health-care system in Germany? This study compared the health-care costs for bilateral risk-reducing mastectomy (BRRM) and risk-reducing (bilateral) salpingo-oophorectomy (RRSO) with cancer treatment costs that could potentially be prevented. PATIENTS AND METHODS: The analysis is based on interdisciplinary consultations with individuals with a high familial risk for breast and ovarian cancer at the University Breast Center for Franconia (Germany) between 2009 and 2013 (370 consultations; 44 patients with BRCA1 mutations and 26 with BRCA2 mutations). Health-care costs for risk-reducing surgeries in BRCA mutation carriers were calculated as reimbursements in the German diagnosis-related groups (DRG) hospital pricing system. These costs for the health-care system were compared with the potential cancer treatment costs that could possibly be prevented by risk-reducing surgeries. RESULTS: Long-term health-care costs can be reduced by risk-reducing surgeries after genetic testing in BRCA mutation carriers. The health-care system in Germany would have saved € 136,295 if BRRM had been performed and € 791,653 if RRSO had been performed before the development of cancer in only 50% of the 70 mutation carriers seen in our center. Moreover, in patients with combined RRSO and BRRM (without breast reconstruction), one further life-year for a 40-year-old BRCA mutation carrier would cost € 2,183. CONCLUSION: Intensive care, including risk-reducing surgeries in BRCA mutation carriers, is cost-effective from the point of view of the health-care system in Germany.
Authors: Stephanie Kearton; Karen Wills; Michael Bunting; Penny Blomfield; Paul A James; Jo Burke Journal: Fam Cancer Date: 2018-07 Impact factor: 2.375
Authors: Marta Stanisz; Mariusz Panczyk; Rafał Kurzawa; Elżbieta Grochans Journal: Int J Environ Res Public Health Date: 2019-12-09 Impact factor: 3.390
Authors: Michael G Schrauder; Lisa Brunel-Geuder; Lothar Häberle; Marius Wunderle; Juliane Hoyer; Roland Csorba; André Reis; Rüdiger Schulz-Wendtland; Matthias W Beckmann; Michael P Lux Journal: Eur J Med Res Date: 2019-09-14 Impact factor: 2.175