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Article Abstract
Purpose: Recent clinical guidelines have broadened the criteria for BRCA counseling and testing for women and men, including indications based on family history, personal history, and current diagnosis of breast, ovarian, pancreatic, and prostate cancer.
Methods: Using claims data from 2013-2022, we identified BRCA testing using procedure codes to evaluate annual utilization, median expenditures per enrollee, and the percentage of zero out-of-pocket (OOP) expenditures by sex among enrollees aged 18-64 years continuously enrolled within calendar years. We examined BRCA utilization by metropolitan status, and indications RESULTS: Annual BRCA testing utilization among women (and men) increased 10.2% (44.5%) per year during 2014-2015 and 1.7% (10.0%) per year during 2016-2019, decreased 34.4% (44.8%) in 2020, rebounded 8.5% (22.3%) per year during 2021-2022, remaining below pre-pandemic levels in 2022. Median expenditures for comprehensive BRCA testing per enrollee decreased by 68% from 2013 to 2022, most of whom had zero OOP expenditures. Most BRCA testing was done based on family health history of breast, ovarian, or prostate cancer and among women aged 18-50 years.
Conclusion: Healthcare providers who are knowledgeable about evolving indications for germline BRCA testing can help ensure that eligible individuals have access to germline BRCA testing as preventive service.
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| http://dx.doi.org/10.1016/j.gim.2025.101556 | DOI Listing |
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