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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Breast Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1419071
This article is part of the Research Topic Multidisciplinary and Personalized Approach in the Treatment of Advanced Breast Cancer View all 20 articles
Cost-effectiveness of companion BRCA testing and adjuvant olaparib treatment in patients with BRCA mutated high-risk HER2-negative early breast cancer
Provisionally accepted- 1 IQVIA (United Kingdom), London, United Kingdom
- 2 Newcastle University, Newcastle upon Tyne, North East England, United Kingdom
- 3 AstraZeneca (United Kingdom), London, England, United Kingdom
As the healthcare industry evolves towards precision medicine, methods to assess the value of integrating companion diagnostics in clinical practice through adequate reimbursement levels are becoming essential. Cost-effectiveness analyses is an established tool used to inform the reimbursement of health technologies.A decision-tree model was developed to estimate the incremental cost effectiveness of companion BRCA testing and olaparib use versus no testing and standard of care for patients with BRCA mutated high-risk HER2-negative early breast cancer from a UK NHS/PSS perspective.BRCA testing combined with treatment with adjuvant olaparib was associated with an ICER of £49,327 per QALY gained and an ICER of £86,349 per QALY gained for TNBC and HER2-/HR+ patients, respectively, compared to no testing and treatment with SoC. This difference in ICER is due to significantly improved outcomes for TNBC patients who were treated with targeted therapy. For both patient subgroups with early breast cancer, testing and olaparib improved patient outcomes and, despite its relatively high cost, the test and treat strategy was deemed to represent an acceptable use of resources.The advancement of high-throughput sequencing technologies, coupled with the rise of targeted treatments in recent years, has facilitated a shift from conventional medical practices to individualised oncology therapeutic approaches. Our analysis presented the value in combining genetic sequencing and targeted therapy for breast cancer patients carrying BRCA mutations, and also provided the prototype of a testing model that can be utilised to promote precision medicine for better patient outcomes.
Keywords: precision medicine, companion diagnostics, cost effectiveness analysis, targeted therapy, biomarker testing
Received: 10 Jun 2024; Accepted: 19 Mar 2025.
Copyright: © 2025 Nikolova, Ma, Sagoo, Punekar and Sheppard. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Elizabeth Sheppard, AstraZeneca (United Kingdom), London, England, United Kingdom
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