Trends in utilization and costs of BRCA testing among women aged 18-64 years in the United States, 2003-2014
Trends in utilization and costs of BRCA testing among women aged 18-64 years in the United States, 2003-2014
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DOI：
10.1038/gim.2017.118
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发表时间：
2018-04-01
影响因子：
8.8
通讯作者：
Khoury, Muin J.
中科院分区：
文献类型：
--
作者：
Chen, Zhuo;Kolor, Katherine;Khoury, Muin J.
目的：我们在临床指南、国家政策和其他因素的背景下研究了BRCA检测率和成本的12年趋势。帕拉;&帕拉;研究方法：我们使用私人索赔数据和主要BRCA检测提供商公开报告的收入，估计了2003年至2014年18-64岁女性的BRCA检测率和成本趋势。帕拉;&帕拉;结果如下：在经历了7年的普遍下降之后，2013-2014年期间，BRCA检测自付费用为零的女性比例有所增加，这与《平价医疗法案》对BRCA基因检测覆盖范围的澄清相吻合。从2007年开始，与个人病史相比，家族病史在接受BRCA检测的妇女中所占比例越来越大，这与初级保健机构的BRCA检测指南和直接面向消费者的广告宣传相吻合。在2013-2014年期间，基于索赔的BRCA检测率的增长速度快于收入，此前3年的增长速度与收入类似，这与市场竞争的加剧是一致的。2013年，基于索赔的BRCA检测率增加了57%，而前3年的平均年增长率为11%，与名人宣传相吻合。帕拉;&帕拉;结论：观察到的BRCA检测率和成本的趋势与几个因素的可能影响一致，包括《平价医疗法案》、临床指南和名人宣传。
Purpose: We examined 12-year trends in BRCA testing rates and costs in the context of clinical guidelines, national policies, and other factors.& para;& para;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.& para;& para;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.& para;& para;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.