COST-CONSEQUENCE MODEL OF WHOLE-EXOME, WHOLE-TRANSCRIPTOME SEQUENCING VERSUS 50-GENE PANELS FOR GENOMIC PROFILING IN ADVANCED SOLID TUMORS
Author(s)
Jesse Ortendahl, MS1, Gebra Cuyun Carter, MPH, PhD2, Elizabeth Zantema, MS1, Jess Hoag, PhD2, Arthur Starodynov, MS2, Karen White, MS2, Gargi Basu, PhD2, Anson Tharayanil, MS2, Jean-Paul De La O, PhD2, David Hall, PhD2, Frederick Baehner, MD2;
1Stratevi, Boston, MA, USA, 2Exact Sciences, Madison, WI, USA
1Stratevi, Boston, MA, USA, 2Exact Sciences, Madison, WI, USA
OBJECTIVES: In oncology practice, next-generation sequencing (NGS) allows the simultaneous detection of multiple predictive biomarkers, which are increasingly being used to guide treatment decisions. NGS panels vary widely in terms of the number and type of genomic alterations assessed, and the optimal approach deserves investigation. This cost-consequence model evaluated the impact of testing using whole-exome, whole-transcriptome sequencing (WES/WTS) versus 50-gene panel tests from a US payer perspective.
METHODS: A previously published Microsoft Excel-based model was used to compare WES/WTS to four 50-gene panels for testing within advanced cancers, including triple-negative breast cancer (TNBC), colorectal cancer (CRC), non-small cell lung cancer (NSCLC), and castrate resistant prostate cancer (CRPC). Genomic alteration prevalence and test sensitivity were based on a previous analysis of WES/WTS results in real-world clinical samples. Model inputs for patient populations, costs, clinical trial uptake, and market share were based on published literature. Results included the number of patients directed to a different therapy and the per-member per-month (PMPM) impact to a health plan when increasing utilization of WES/WTS testing.
RESULTS: In a one-million-member hypothetical plan, 858 patients were eligible for tumor profiling. Across the four 50-gene panel tests, the number of patients switching treatment when using WES/WTS testing was 1-2 (TNBC), 4-6 (CRC), 1-6 (NSCLC), and 3-5 (CRPC). PMPM cost differences when replacing use of 50-gene panels with WES/WTS ranged from a cost-savings of $0.0517 in NSCLC to a $0.0268 increase in CRPC. Per-patient costs when using WES/WTS testing were driven by medical and pharmacy costs, with testing representing only 1.1%-2.1% of total costs.
CONCLUSIONS: This study adds to the growing body of research on the value of WES/WTS-based testing approaches to guide personalized treatment pathways. The findings support the economic and clinical benefits of using WES/WTS over 50-gene panels in advanced cancer and call for expanding access to improve patient outcomes.
METHODS: A previously published Microsoft Excel-based model was used to compare WES/WTS to four 50-gene panels for testing within advanced cancers, including triple-negative breast cancer (TNBC), colorectal cancer (CRC), non-small cell lung cancer (NSCLC), and castrate resistant prostate cancer (CRPC). Genomic alteration prevalence and test sensitivity were based on a previous analysis of WES/WTS results in real-world clinical samples. Model inputs for patient populations, costs, clinical trial uptake, and market share were based on published literature. Results included the number of patients directed to a different therapy and the per-member per-month (PMPM) impact to a health plan when increasing utilization of WES/WTS testing.
RESULTS: In a one-million-member hypothetical plan, 858 patients were eligible for tumor profiling. Across the four 50-gene panel tests, the number of patients switching treatment when using WES/WTS testing was 1-2 (TNBC), 4-6 (CRC), 1-6 (NSCLC), and 3-5 (CRPC). PMPM cost differences when replacing use of 50-gene panels with WES/WTS ranged from a cost-savings of $0.0517 in NSCLC to a $0.0268 increase in CRPC. Per-patient costs when using WES/WTS testing were driven by medical and pharmacy costs, with testing representing only 1.1%-2.1% of total costs.
CONCLUSIONS: This study adds to the growing body of research on the value of WES/WTS-based testing approaches to guide personalized treatment pathways. The findings support the economic and clinical benefits of using WES/WTS over 50-gene panels in advanced cancer and call for expanding access to improve patient outcomes.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE363
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
SDC: Oncology, STA: Personalized & Precision Medicine