Cost Savings of Expedited Care with Upfront Next-Generation Sequencing Testing versus Single-Gene Testing among Patients with Metastatic Non-Small Cell Lung Cancer Based on Current Canadian Practices
Current Oncology, 2023
Next-generation sequencing (NGS) testing is a clinical guideline-recommended method of broad molecular profiling that enables upfront and simultaneous detection of common and rare actionable mutations in metastatic non-small cell lung cancer (mNSCLC). In particular, relative to single-gene testing, NGS has been shown to lead to the correct identification of a greater number of actionable alterations in mNSCLC. It has also been shown to reduce the time needed to test samples, the need for retesting and repeat biopsies, and, as a result, the time to initiate appropriate targeted therapy. These findings have highlighted the need to assess whether NGS is associated with lower overall testing costs as well.
An Analysis Group team collaborated with researchers from the William Osler Health System and Janssen Pharmaceuticals to estimate the costs associated with delays in the initiation of treatment for NGS versus single-gene testing among patients with newly diagnosed mNSCLC, from a Canadian public-payer perspective. Using a decision tree model, the team created a comprehensive assessment of the costs of testing that included estimated costs of delaying care, genetic testing costs, medical costs of rebiopsies, and the costs of visiting oncologists and interventional radiologists. They found that NGS testing resulted in more patients testing positive for a mutation, a shorter time to appropriate targeted therapy initiation, and lower per-patient total testing costs of $3,480, compared to $5,632 for single-gene testing strategies.
In an article in Current Oncology reporting the results, the authors – who included Analysis Group Managing Principal Patrick Lefebvre, Vice Presidents Bruno Emond and Marie-Hélène Lafeuille, Manager Laura Morrison, and Senior Research Professional Annalise Hilts – wrote that “[p]olicies that aim to allocate and standardize funding for NGS across Canada warrant consideration.”
Authors
Sheffield BS, Eaton K, Emond B, Lafeuille MH, Hilts A, Lefebvre P, Morrison L, Stevens AL, Ewara EM, Cheema P