Table 1

Costs (undiscounted and discounted (3%)) and savings per patient with BC screened by the BRCA mutation approach (alternative 1) or the traditional FH approach (alternative 2)

Costs (C)Unit costAlternative 1
Screening
(€)
Alternative 1
Screening
(€) 3 % d r
Alternative 2
FH approach
(€)
Alternative 2
FH approach
(€) 3% dr
Patients with BC
Healthcare costs (C1)
 Visit to breast surgeon311311311311311
 BCS (DRG 260O) (70%)17581231123112311231
 Visit to a geneticist701133
 Mastectomy (DRG 258) (30%)2312694694694694
 Radiotherapy (75%)44573343334333433343
 Adjuvant hormonal therapy (50%)1819910858910858
 Adjuvant chemotherapy (75%)60004500450045004500
 Zoledronic acid (50%)138690617690617
 Reconstruction (12%)8089971971971971
 Screening for mutation516342464246319319
BRCA INDEL screening94800283283
 PBM (DRG 502)15 6943813818888
 PBSO (DRG 359O)231556561313
 Hormonal replacement therapy787191744
Sum C117 35317 22613 36013 235
Patient-related costs (C2)
 Visit surgeon3535353535
 Visit geneticist351122
 Visit oncologist/radiotherapist35261261261261
 Travelling29536536537537
Sum C2833833835835
Cost in other sectors (C3)
 Production loss19 12319 12319 12319 12319 123
Sum C319 12319 12319 12319 123
Family members
Healthcare costs (C12)
 Genetic counselling707722
 Genetic testing, mutation known676611
 Visit to surgeon (DRG 930O)1357722
 PBM (DRG 502)15 694763763176176
 Visit to gynaecologist (DRG 913O)1407722
 PBSO DRG 359O23151131002623
 Hormonal replacement therapy787383497
Sum C12 941920218213
Patient-related costs (C22)
 Visit to surgeon (patient share)352211
 Visit to geneticist (patient share)352211
 Travelling593311
Sum C22 7733
Cost in other sectors (C32)
 Production loss318777773030
Sum C32 77773030
 Sum C1, C2, C3, C12, C22, C32 38 33437 26433 34133 214
Patients with BC
Healthcare savings (S1)
 Breast cancer diagnosis3118733
 Mammography175843401615
 Mastectomy (DRG 258)2312171666
 BCS (DRG 260O) (70%)175830281111
 Adjuvant hormonal therapy1819111044
 Adjuvant chemotherapy (75%)60001091034240
 Reconstruction (12%) 24 22 998089242299
 Radiotherapy (75%)445781773129
 Ovarian cancer diagnosis (DRG 913O)1403311
 Ovarian cancer surgery (DRG 357)1404311
Sum S1330309124119
Patient-related savings (S2)
 Visit to surgeon (patient share)351100
 Visit to gynaecologist (patient share)351100
 Visit to oncologist/radiotherapist356622
 Travelling29735692283266
Sum S2743700285268
Savings in other sectors (S3)
 Production gain (unit=per year)38 2475111454519661748
Sum S35111454519661748
 Sum S1, S2, S36184555423752135
  • BC, breast cancer; BCS, breast conserving surgery; dr, discount rate; DRG, diagnosis-related group; FH, family history; INDEL, insertion or deletion of bases; PBM, prophylactic bilateral mastectomy; PBSO, prophylactic bilateral salpingo-oophorectomy.