PT  - JOURNAL ARTICLE
AU  - Ingrid Slade
AU  - Helen Hanson
AU  - Angela George
AU  - Kelly Kohut
AU  - Ann Strydom
AU  - Sarah Wordsworth
AU  - Nazneen Rahman
AU  - MCG Programme
TI  - A cost analysis of a cancer genetic service model in the UK
AID  - 10.1101/027185
DP  - 2015 Jan 01
TA  - bioRxiv
PG  - 027185
4099  - http://biorxiv.org/content/early/2015/09/18/027185.short
4100  - http://biorxiv.org/content/early/2015/09/18/027185.full
AB  - Background Technological advances in DNA sequencing have made gene testing fast and more affordable. Evidence of cost-effectiveness of genetic service models is essential for successful translation, but remain sparse in the literature. In particular there is a lack of cost data related to genetic services.Methods A detailed micro-costing of 28 pathways relating to breast and/or ovarian cancer and gene testing for the BRCA1 and BRCA2 genes (termed ‘BRCA testing’) was carried out. These data were combined with patient-level data from a Royal Marsden Cancer Genetics Service audit during which BRCA testing was offered to individuals at ≥10% risk of having a mutation.Results The average cost across all pathways was £2,222.68 (range £376.47-£13,531.24). The average pathway cost for a person with cancer was £1897.71 compared to £2,403.22 for a person without cancer. Of the women seen during audit period, 38% were affected with breast and/or ovarian cancer and 62% were unaffected but concerned about their family history.Conclusion There is considerable variation in the costs of different gene testing pathways. Improved cost-efficiency could be achieved by increasing the proportion of cancer patients tested, because the pathway cost of an unaffected individual in whom testing has already been performed in a relative with cancer is considerably less.Acknowledgements We acknowledge NHS funding to the Royal Marsden/ICR NIHR Specialist Biomedical Research Centre for Cancer. SW is supported by funding through the NIHR Oxford Biomedical Research Centre. This work was supported by Wellcome Trust Award 098518/Z/12/Z. For MCG programme see www.mcgprogramme.com.Conflict of Interest Statement There are no conflicts of interests for any author of this paper