Primary findings
HER2-negative, TNBC, death
HER2-NEGATIVE BREAST CANCER
Our analysis demonstrates that gBRCA testing for all patients with HER2-negative breast cancer, including TNBC and HR-positive HER2-negative breast cancer, is cost-effective and has a clinical benefit. To confirm these findings, we performed a stepwise validation of the cost-effectiveness of gBRCA testing and adjuvant olaparib use. Considering the clinical benefits of PARPi and RROs for HER2-negative BC, we assessed the cost-effectiveness of expanding the gBRCA testing to HER2-negative BC patients from TNBC. Surprisingly, moving toward such a universal policy could lead to fewer patients (1.5%/1.3%) suffering from death and more patients (1.7%/1.4%) achieving DF state with an acceptable additional financial burden of 255.9 and 2196.4 USD (ICERs of 2023.3 and 16,611.1 USD/QALY) in China and the USA, respectively. Regarding the WTP in China and the USA being 31,500.0 USD/QALY and 100,000.0 USD /QALY [