The Potential Effect of Future Medical Cost Changes on the Net Cost of Multi-Cancer Early Detection Testing

OBJECTIVES: Multi-cancer early detection (MCED) testing along with standard of care (SoC) could improve survival outcomes and lower treatment costs but increase screening costs. Spending on cancer therapeutics in the US is projected to increase >10% annually over the next 5 years, while cost of lab testing has generally remained flat or decreased over time. This study explores the effect of the differential in future cost changes between cancer treatment and MCED testing on the economic impact of MCED testing.

METHODS: A state-transition model compared annual MCED testing for ages 50-79 plus SoC with SoC alone. Nineteen solid cancer groupings representing 80% of cancer incidence were considered. Medical costs were accrued for patients over their lifetime; constant annual cost growth rates were applied to treatment, workup and SoC screening costs. MCED cost was assumed to remain constant over time. The analysis estimated the cost growth rate which yielded cost-neutrality over the patients’ lifetime between testing with MCED plus SoC versus SoC alone in a commercial population. A conservative scenario analysis assumed future growth of cancer treatment costs matches the historical inflation rate for overall medical costs (Medical Services CPI; 3.1%).

RESULTS: At MCED cost of $949, MCED plus SoC and SoC alone were cost-neutral at a treatment cost growth rate of 2.6% in a commercial population. Above this growth rate, total lifetime costs were lower in the MCED arm. If future growth of cancer treatment costs falls to match the historical annual inflation rate for overall medical costs, MCED plus SoC and SoC alone are cost neutral for a $1,091 MCED test cost.

CONCLUSIONS: MCED testing may help reduce the impact of future treatment cost increases, achieving cost-neutrality or saving along with improved survival if treatment costs are increasing at ≥2.6% annually.