Abstract
Cost-effectiveness of BRAFV600E Mutation Testing in Patients with Metastatic Melanoma: Immunohistochemistry vs Polymerase Chain Reaction
Journal of the American College of Surgeons, Vol.223(4), pp.e184-e184
10/2016
DOI: 10.1016/j.jamcollsurg.2016.08.466
Abstract
Introduction
Immunohistochemistry (IHC) test has been suggested recently to replace polymerase chain reaction (PCR) for detecting BRAFV600E mutation in patients with metastatic melanomas. In this study, we aim to assess the cost savings produced by adopting IHC instead of PCR in advanced melanoma in the United States (US).
Methods
Surveillance, Epidemiology, and End Results (SEER) data was used to identify the number of new cases of melanoma in the US in 2015. Costs of PCR and IHC were determined from Medicare Schedule Fee.
Results
In the US, it is estimated that 11,081 cases of advanced melanoma, stages III and IV, will be diagnosed in 2015. About 4,986 (45%) of those patients could harbor BRAFV600E mutation. With assumption that PCR has a sensitivity of (99%) and IHC has a sensitivity of (97%), false negative results will be expected in approximately 50 patients test with PCR and 150 patients tested with IHC; and those patients would miss appropriate treatment utilizing selective BRAF inhibitors. Accounting for the cost associated with false negative rate, and given that the incidence of melanoma has been stable in the US over the last decade, adopting IHC instead of PCR could produce a net cost savings of $5.22 million/year in patients receiving selective BRAF inhibitors.
Conclusions
IHC is associated with substantial cost savings compared to PCR in detecting BRAFV600E mutation. Nonetheless, 3% of patients with metastatic melanoma would miss a chance of appropriate treatment utilizing selective BRAF inhibitors if they were tested with IHC compared to 1% false negative rate of PCR.
Details
- Title: Subtitle
- Cost-effectiveness of BRAFV600E Mutation Testing in Patients with Metastatic Melanoma: Immunohistochemistry vs Polymerase Chain Reaction
- Creators
- Zaid Al-QurayshiMuhammad A. Anwar - Tulane UniversityZakaria Y. Abd ElmageedAndrew B. Sholl - Tulane UniversityEmad Kandil - Tulane University
- Resource Type
- Abstract
- Publication Details
- Journal of the American College of Surgeons, Vol.223(4), pp.e184-e184
- Publisher
- ELSEVIER SCIENCE INC
- DOI
- 10.1016/j.jamcollsurg.2016.08.466
- ISSN
- 1072-7515
- eISSN
- 1879-1190
- Language
- English
- Date published
- 10/2016
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984702898302771
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