Cost-effectiveness analysis and budget impact analysis of next-generation sequencing panel including BRCA1 and BRCA2 genes for women diagnosed with non-metastatic breast cancer in Brazil

Autores

  • Henrique Lima Couto Centro de Referência no Diagnóstico Mamário – Belo Horizonte (MG), Brazil.
  • Rosemar Macedo de Souza Rahel Universidade Federal de Goiás – Goiânia (GO), Brazil.
  • Ludmila Peres Gargano Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Farmácia Social – Belo Horizonte (MG), Brazil.
  • Fernando Zanghelini Universidade Federal de Pernambuco, Programa de Pós-Graduação de Inovação Terapêutica – Recife (PE), Brazil.
  • Agnaldo Lopes da Silva filho Universidade Federal de Minas Gerais – Belo Horizonte (MG), Brazil.
  • Augusto Tuf Hassan Sociedade Brasileira de Mastologia – Brazil.
  • Angélica Nogueira Rodrigues Sociedade Brasileira de Oncologia Clínica – Brazil.
  • Bertha Andrade Coelho Sociedade Brasileira de Mastologia – Brazil.

DOI:

https://doi.org/10.29289/259453942025V35S1044

Palavras-chave:

breast cancer, BRCA1 protein, BRCA2 protein, cost-effectiveness analysis, analysis of the budgetary impact of therapeutic advances

Resumo

Objective: This study aimed to estimate both the cost-effectiveness and budget impact of using next-generation sequencing panels with genetic counselling to detect BRCA1/2 mutations in women diagnosed with non-metastatic breast cancer
and compare to no genetic testing, from the perspective of the Brazilian Public Health System. Methods: A hybrid economic model (decision tree plus Markov model) simulated costs and outcomes over a 10-year horizon of next-generation
sequencing panels with genetic counselling to identify BRCA1/2 pathogenic variants in women diagnosed with non-metastatic breast cancer. The eligible population was estimated using the epidemiological method with national data identified in the literature. We estimated both the incremental cost-effectiveness ratio per quality-adjusted life year (QALY)
gained and the budget impact of adding next-generation sequencing panels plus genetic counselling to identify pathogenic variants in BRCA1/2 in women diagnosed with non-metastatic breast cancer. Results: Genetic testing for BRCA1/2
mutations combined with genetic counselling showed an incremental benefit of 0.044 QALYs gained at an additional
cost of R$ 3.314,83 compared to no genetic testing and genetic counselling, resulting in an incremental cost-effectiveness
ratio of R$ 75.961,11 per QALY gained. Considering the expected number of women, the cumulative budget impact over
five years with the availability of genetic testing for BRCA1/2 and genetic counselling would be R$ 31.104.761,08, based on
the current scenario (without BRCA1/2 test and genetic counselling). Conclusion: Genetic testing for BRCA1/2 mutations combined with genetic counselling was cost-effective from the Brazilian Public Health System perspective, with
an incremental cost-effectiveness ratio value below the established willingness-to-pay threshold of R$ 120,000.00/QALY.

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Publicado

2026-02-24

Como Citar

Couto, H. L., Rahel, R. M. de S., Gargano, L. P., Zanghelini, F., Silva filho, A. L. da, Hassan, A. T., … Coelho, B. A. (2026). Cost-effectiveness analysis and budget impact analysis of next-generation sequencing panel including BRCA1 and BRCA2 genes for women diagnosed with non-metastatic breast cancer in Brazil. Mastology, 35(suppl.1). https://doi.org/10.29289/259453942025V35S1044

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