{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:16:34Z","timestamp":1782180994973,"version":"3.54.5"},"reference-count":67,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"unspecified","delay-in-days":64,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000927","name":"Prostate Cancer Foundation of Australia","doi-asserted-by":"publisher","award":["Priority Impact Research Award"],"award-info":[{"award-number":["Priority Impact Research Award"]}],"id":[{"id":"10.13039\/501100000927","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1116334"],"award-info":[{"award-number":["1116334"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1136923"],"award-info":[{"award-number":["1136923"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Technol Assess Health Care"],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S0266462324000011_sec1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Olaparib targets the DNA repair pathways and has revolutionized the management of metastatic castration resistant prostate cancer (mCRPC). Treatment with the drug should be guided by genetic testing; however, published economic evaluations did not consider olaparib and genetic testing as codependent technologies. This study aims to assess the cost-effectiveness of <jats:italic>BRCA<\/jats:italic> germline testing to inform olaparib treatment in mCRPC.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0266462324000011_sec2\" sec-type=\"methods\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>We conducted a cost-utility analysis of germline <jats:italic>BRCA<\/jats:italic> testing-guided olaparib treatment compared to standard care without testing from an Australian health payer perspective. The analysis applied a decision tree to indicate the germline testing or no testing strategy. A Markov multi-state transition approach was used for patients within each strategy. The model had a time horizon of 5\u00a0years. Costs and outcomes were discounted at an annual rate of 5 percent. Decision uncertainty was characterized using probabilistic and scenario analyses.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0266462324000011_sec3\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Compared to standard care, <jats:italic>BRCA<\/jats:italic> testing-guided olaparib treatment was associated with an incremental cost of AU$7,841 and a gain of 0.06 quality-adjusted life-years (QALYs). The incremental cost-effectiveness ratio (ICER) was AU$143,613 per QALY. The probability of <jats:italic>BRCA<\/jats:italic> testing-guided treatment being cost effective at a willingness-to-pay threshold of AU$100,000 per QALY was around 2 percent; however, the likelihood for cost-effectiveness increased to 66 percent if the price of olaparib was reduced by 30 percent.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0266462324000011_sec4\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusion<\/jats:title>\n\t    <jats:p>This is the first study to evaluate germline genetic testing and olaparib treatment as codependent technologies in mCRPC. Genetic testing-guided olaparib treatment may be cost-effective with significant discounts on olaparib pricing.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s0266462324000011","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T07:31:21Z","timestamp":1709623881000},"source":"Crossref","is-referenced-by-count":9,"title":["The cost-effectiveness of germline BRCA testing-guided olaparib treatment in metastatic castration resistant prostate cancer"],"prefix":"10.1017","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2818-840X","authenticated-orcid":false,"given":"Srinivas","family":"Teppala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5931-642X","authenticated-orcid":false,"given":"Paul A.","family":"Scuffham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2993-3480","authenticated-orcid":false,"given":"Haitham","family":"Tuffaha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"S0266462324000011_r4","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1056\/NEJMoa1603144","article-title":"Inherited DNA-repair gene mutations in men with metastatic prostate cancer","volume":"375","author":"Pritchard","year":"2016","journal-title":"N Engl J Med."},{"key":"S0266462324000011_r6","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1200\/JCO.2012.43.1882","article-title":"Germline BRCA mutations are associated with higher risk of nodal involvement, distant metastasis, and poor survival outcomes in prostate cancer","volume":"31","author":"Castro","year":"2013","journal-title":"J Clin Oncol."},{"key":"S0266462324000011_r18","unstructured":"18. NCCN. Clinical practice guidelines in oncology, prostate cancer. Version 4. 2022. Available from: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/prostate.pdf."},{"key":"S0266462324000011_r56","unstructured":"56. NICE. Olaparib for previously treated BRCA mutation-positive hormone-relapsed metastatic prostate cancer [TA887]. 2023. 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