Journal of Community Genetics

, Volume 8, Issue 2, pp 141–146 | Cite as

The effect of a celebrity health disclosure on demand for health care: trends in BRCA testing and subsequent health services use

Original Article

Abstract

In May 2013, an internationally renowned celebrity—Angelina Jolie—disclosed her receipt of BRCA1/BRCA2 (BRCA) testing and subsequent double mastectomy in a highly publicized editorial. Publicity surrounding celebrity health services use increases awareness of important health issues and demand for health services. We aimed to describe BRCA testing trends before and after Jolie’s disclosure, breast cancer-related services use following testing, and test reimbursement trends. MarketScan Commercial Claims data were used to compare trends in BRCA testing before and after Jolie’s health disclosure using an interrupted time series model among women aged 18–64. We used modified Poisson regression to estimate risks for health services use (surgical consult, mastectomy, mammography, magnetic resonance imaging, genetic counseling) following BRCA testing. BRCA testing rates increased from 12.5 to 19.0 tests/100,000 women between January 2013 and October 2014. Immediately following Jolie’s disclosure, testing increased by approximately 37% (p < 0.001). Although BRCA testing increased, use of post-testing follow-up services declined after Jolie’s disclosure. Mean insurance reimbursement and patient out-of-pocket spending on the test decreased by 3 and 36%, respectively. While genetic testing uptake increased following Jolie’s disclosure, subsequent health services use associated with BRCA mutations declined, suggesting that celebrity disclosures may be associated with potential genetic testing overuse.

Keywords

Genetic testing Breast cancer Costs Health services use 

Notes

Acknowledgements

This project was unfunded. Dr. Roberts was funded by the UNC Lineberger Cancer Control Education Program (CCEP) (R25 CA57726). Dr. Dusetzina receives salary support from the BIRCWH K12 Program and the North Carolina Translational and Clinical Sciences Institute (UL1TR001111).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

This article does not contain any studies with human or animal subjects performed by the any of the authors.

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Copyright information

© Springer-Verlag Berlin Heidelberg (outside the USA) 2017

Authors and Affiliations

  1. 1.Gillings School of Global Public Health, Department of Health Policy and ManagementUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.UNC Lineberger Comprehensive Cancer CenterChapel HillUSA
  3. 3.Division of Pharmaceutical Outcomes and PolicyUNC Eshelman School of PharmacyChapel HillUSA
  4. 4.Cecil G. Sheps Center for Health Services ResearchUniversity of North Carolina at Chapel HillChapel HillUSA

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