Pre-implantation genetic testing for BRCA gene mutation carriers: a cost effectiveness analysis
For some communities ovarian cancer is a real and constant threat, none more so than for the Ashkenazi in Israel. Ovarian cancer is related to an inherited condition in about 25% of cases. The Ashkenazi have a high incidence of BRCA1/2 mutation, which increases the likelihood of developing ovarian cancer compared to the general population.
One strategy for avoiding ovarian cancer and the common fatal consequence is by prevention through pre-implantation genetic screening and selection of embryos, as part of In Vitro Fertilisation (IVF). This study seeks to determine the cost-effectiveness of doing this for parents who carry the BRCA1/2 gene.
Cost-effectiveness is routinely determined as a measure known as the Quality Affected Year (QALY), meaning the value of a year without disease. Most advanced economies put the acceptable cost at a QALY of around $US 40,000. Results from the study suggest a QALY cost for the IVF embryo screening strategy at $US 44,000. This may be acceptable for small high-risk communities such as the Ashkenazi.
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