Trends in utilization and costs of BRCA testing among women aged 18–64 years in the United States, 2003–2014

Chen, Zhuo and Kolor, Katherine and Grosse, Scott D and Rodriguez, Juan L and Lynch, Julie A and Green, Ridgely Fisk and Dotson, W David and Bowen, M Scott and Khoury, Muin J (2017) Trends in utilization and costs of BRCA testing among women aged 18–64 years in the United States, 2003–2014. Genetics in Medicine, 20 (4). pp. 428-434. ISSN 1098-3600

[img]
Preview
PDF - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (697kB) | Preview

Abstract

Purpose

We examined 12-year trends in BRCA testing rates and costs in the context of clinical guidelines, national policies, and other factors.

Methods

We estimated trends in BRCA testing rates and costs from 2003 to 2014 for women aged 18–64 years using private claims data and publicly reported revenues from the primary BRCA testing provider.

Results

The percentage of women with zero out-of-pocket payments for BRCA testing increased during 2013–2014, after 7 years of general decline, coinciding with a clarification of Affordable Care Act coverage of BRCA genetic testing. Beginning in 2007, family history accounted for an increasing proportion of women with BRCA tests compared with personal history, coinciding with BRCA testing guidelines for primary care settings and direct-to-consumer advertising campaigns. During 2013–2014, BRCA testing rates based on claims grew at a faster rate than revenues, following 3 years of similar growth, consistent with increased marketplace competition. In 2013, BRCA testing rates based on claims increased 57%, compared with 11% average annual increases over the preceding 3 years, coinciding with celebrity publicity.

Conclusion

The observed trends in BRCA testing rates and costs are consistent with possible effects of several factors, including the Affordable Care Act, clinical guidelines and celebrity publicity.

Item Type: Article
Additional Information: 6 months embargo for archiving post-print
Keywords: BRCA testing
Schools/Departments: University of Nottingham Ningbo China > Faculty of Humanities and Social Sciences > School of Economics
Identification Number: https://doi.org/10.1038/gim.2017.118
Depositing User: Zhou, Elsie
Date Deposited: 10 Aug 2018 07:57
Last Modified: 10 Aug 2018 07:57
URI: http://eprints.nottingham.ac.uk/id/eprint/53310

Actions (Archive Staff Only)

Edit View Edit View