Table 3 Results of economic evaluation of selected studies

Lim et al. (2018) [30]

Local Hospital

451.5 (2016) → 509.31 (2022)

Literature Search from Other Countries

9500 USD/QALY (1 time GDP per capita)

Incremental Costs per QALY (ICERs), Incremental Costs per LYS (ICERs)

• ICER: USD 2566/QALY; USD 918/life-year saved

• Genetic testing is cost-effective compared to routine clinical surveillance as it was below WTP threshold.

Sun et al. (2022) [32]

Sampling database of the Chinese Urban Basic Medical Insurance

367 (2019) → 390.36 (2022)

Lifetime Tables from each country were obtained from the World Health Organization (WHO) and

published literatures.

10,262 USD/QALY (1 time GDP per capita)

Incremental Costs per QALY (ICERs), Incremental Costs per LYG (ICERs)

• Multigene testing for all BC patients VS No genetic testing USD 4793/QALY, USD 4294/LYG (Societal) & USD 7729/QALY, USD 6923/LYG (payer perspective)

• Unselected multigene testing to all BC patients in China is cost-effective as compared with no testing or selected testing as it was below WTP threshold

Wu et al. (2023) [29]

Price Announcement by the Shanghai Health Minister of China

308.6 (2021) → 314.98 (2022)

Published literatures

31,500 USD /QALY

Primary Outcome: QALY gained & ICERs Secondary Outcome:

life expectancy gained & survival outcome

• Universal gBRCA testing among TNBC patient compared with no testing and selected testing respectively, ICERs of USD 10,812/QALY and USD 11,218 /QALY

• Universal testing for all HER2-negative BC patients compared with no testing and selected testing respectively, with ICERs of USD 2214/QALY & USD 2065/QALY.

• Universal gBRCA testing is cost-effective as the ICER value is below the WTP threshold.

Genetic Testing for Breast Cancer and Ovarian Cancer

Manchanda et al. (2020) [31]

China

Urban Basic Medical Insurance Database;

Brazil

Management System of Procedures/Medical drugs/Orthotics/Prosthetics/Special Materials (SIGTAP), the Health Price Bank (BPS), and Chamber of Regulation of the Market of Medicines (CMED);

India

Accredited Cancer Centre Tata Medical Centre

200 (2016) → 225.61 (2022)

Lifetime Tables from each country were obtained from the World Health Organization (WHO);

QALY values obtained from published literatures.

China: ($15,531/QALY-$46,592/QALY)

Brazil: ($15,182/QALY-$45,545/QALY

India: ($6574/QALY-$19,722/QALY)

WTP were based on 1–3 times GDP of each country

Lifetime costs and QALYs, ICERs

• ICER

China

Societal: USD 26,716/LY, USD 20,379/QALY

Payer: USD 34,730/LY, USD 26,492/QALY

Brazil

Societal: USD 17,873/LY, USD 15,318/QALY

Payer: USD 27,632/LY, USD 23,683/QALY

India

Societal: USD 31,831/LY, USD 25,980/QALY

Payer: USD 44,527/LY, USD 36,342/QALY

• BRCA testing is cost-effective in both China and Brazil except India from both payer and societal perspective when compared to the WTP threshold set in the study

Simoes Correa-Galendi et al. (2021) [33]

Official Brazilian Universal Health Coverage System (SUS) database and local distributors

1480 (2019) → 1574.22 (2022)

Several systematic literature searches in Medline and BIREME (a Latin American health database)

Not well defined

Incremental Costs per QALY (ICERs), Incremental Costs per LYG (ICERs)

• ICER: USD 12,472/QALY & USD 14,013/ LYG

• Cost-effectiveness of BRCA testing is still depends on undecided cost-effectiveness threshold. The ICER is 1.04 times the GDP per capita

Lourencao et al. (2022) [34]

Official Brazilian Universal Health Coverage System (SUS) database

524.98 (2021)→ 535.84 (2022)

Published studies from a systematic literature search in the PubMed database

R$ 25,000/QALY (U$ 11, 563.37/QALY)

Based on the lowest thresholds reported in National Commission for the Incorporation of Technologies (CONITEC)

Incremental Costs per QALY (ICERs), Incremental Costs per LYG (ICERs)

• ICER: USD 5618/QALY and USD 5188/ LYG

• BRCA testing is cost-effective if the WTP is USD 11,563.37/QALY