loading page

Preimplantation genetic testing for BRCA gene mutation carriers: a cost effectiveness analysis
  • +4
  • Nadav Michaan,
  • Moshe Lashno,
  • Yoni Cohen,
  • Tamar Safra,
  • Shira Peleg-Hasson,
  • Dan Grisaru,
  • Ido Laskov
Nadav Michaan
Tel Aviv Sourasky Medical Center
Author Profile
Moshe Lashno
Tel Aviv Sourasky Medical Center
Author Profile
Yoni Cohen
Tel Aviv Sourasky Medical Center
Author Profile
Tamar Safra
Tel Aviv Sourasky Medical Center
Author Profile
Shira Peleg-Hasson
Tel Aviv Sourasky Medical Center
Author Profile
Dan Grisaru
Tel Aviv Sourasky Medical Center
Author Profile
Ido Laskov
Tel Aviv Sourasky Medical Center
Author Profile

Abstract

Objective: Gynecologic oncologists should be aware of the option of conception through IVF/PGT-M for families with high BRCA related morbidity or mortality. Our objective was to investigate the cost-effectiveness of preimplantation genetic testing for selection and transfer of BRCA negative embryo in BRCA mutation carriers compared to natural conception. Design: Markovian process decision analysis model comparing two strategies, conception through IVF/PGT-M and BRCA negative embryo transfer and natural conception with a 50% chance of BRCA positive newborn. Setting: Not applicable Population: Theoretical couple, with either one parent carrying a BRCA germ line mutation. Intervention: None Methods: Costs of two strategies were compared using quality adjusted life years (QALYs’). All costs were discounted at 3%. Main outcome measure: Incremental cost effectiveness ratio (ICER) compared to willingness to pay threshold was used for cost-effectiveness analysis. Results: IVF/ PGT-M is cost-effective with an ICER of 150,219 new Israeli Shekels, per QALY gained (equivalent to 44,480 USD), at a 3% discount rate. Conclusion: IVF/ PGT-M and BRCA negative embryo transfer compared to natural conception among BRCA positive parents is cost effective and should be considered for selected couples with high BRCA mutation related morbidity. Funding: No funding of any kind was received for this article