The cost-utility of Magnetic Resonance Imaging for breast cancer in BRCA1 mutation carriers aged 30-49

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Journal Article
European Journal of Health Economics, 2007, 8 (2), pp. 137 - 144
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Recent evidence has investigated the costeffectiveness of magnetic resonance imaging (MRI) in younger women with a BRCA1 mutation. However, this evidence has not been contrasted with existing cost-effectiveness standards to determine whether screening is appropriate, given limited societal resources. We constructed a Markov model investigating surveillance tools (mammography, MRI, both in parallel) under a National Health Service (NHS) perspective. The key benefit of MRI is that increased sensitivity leads to early detection, and improved prognosis. For a 30- to 39-year-old cohort, the cost per quality-adjusted life year (QALY) of mammography relative to no screening was £5,200. The addition of MRI to this costs £13,486 per QALY. For a 40- to 49- year-old cohort, the corresponding values were £2,913 and £7,781. Probabilistic sensitivity analysis supported the cost-effectiveness of the parallel approach of mammography and MRI. It is necessary to extend this analysis beyond BRCA1 carriers within this age group, and also to other age groups.
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