Budget Impact Analysis of Early FGFR3 Testing in Metastatic Urothelial Carcinoma: A Finnish Healthcare Perspective
Author(s)
Salla Oinasmaa, M.Sc.1, Mika Pietilä, P.hD.1, Vivi Mauno, M.Sc.2, Tuukka Hakkarainen, M.Sc.2.
1Johnson & Johnson Innovative Medicine, Espoo, Finland, 2Nordic Healthcare Group, Espoo, Finland.
1Johnson & Johnson Innovative Medicine, Espoo, Finland, 2Nordic Healthcare Group, Espoo, Finland.
OBJECTIVES: To assess the budgetary impact of implementing routine FGFR3 alteration testing at initiation of first-line (1L) therapy in metastatic urothelial carcinoma (mUC), addressing hospital concerns regarding potential cost escalation associated with routine FGFR3 testing.
METHODS: A budget impact analysis was conducted from the Finnish hospital perspective, comparing two FGFR3 testing strategies: (1) no FGFR3 testing, and (2) FGFR3 alteration testing at initiation of 1L therapy. The analysis included hospital costs related to mUC medications and FGFR3 testing procedures. A decision-tree model was developed using data from Finnish national registries, literature, and expert opinions. Hospital costs were evaluated over a lifetime horizon for patient care pathways, including a 5-year budget impact analysis. Deterministic one-way and two-way sensitivity analyses assessed result robustness. Additionally, a scenario analysis evaluated the impact of FGFR3 testing at the end of 1L therapy.
RESULTS: Implementing 1L FGFR3 testing marginally increased initial hospital expenses due to upfront testing costs. However, early detection of FGFR3-positive patients facilitated timely initiation of second-line targeted therapy (erdafitinib), which is administered in outpatient settings and reimbursed through social insurance. Consequently, routine FGFR3 testing did not significantly increase long-term overall hospital expenditure. The average hospital lifetime cost per mUC patient with FGFR3 testing was €154,701, €2,501 (1.6%) lower compared to no testing. Over five years, routine FGFR3 testing could achieve hospital savings of €127,562 (1.6%) for a hospital treating 10 mUC patients annually. Sensitivity analyses indicated key parameters influencing the results, notably FGFR3 test costs, FGFR3 alteration prevalence and hospital drug prices.
CONCLUSIONS: This analysis suggests that the long-term financial implications of 1L FGFR3 testing and targeted treatment can offset the initial costs associated with testing. These findings may reassure hospital management regarding financial feasibility and support the adoption of FGFR3 testing in mUC clinical practice.
METHODS: A budget impact analysis was conducted from the Finnish hospital perspective, comparing two FGFR3 testing strategies: (1) no FGFR3 testing, and (2) FGFR3 alteration testing at initiation of 1L therapy. The analysis included hospital costs related to mUC medications and FGFR3 testing procedures. A decision-tree model was developed using data from Finnish national registries, literature, and expert opinions. Hospital costs were evaluated over a lifetime horizon for patient care pathways, including a 5-year budget impact analysis. Deterministic one-way and two-way sensitivity analyses assessed result robustness. Additionally, a scenario analysis evaluated the impact of FGFR3 testing at the end of 1L therapy.
RESULTS: Implementing 1L FGFR3 testing marginally increased initial hospital expenses due to upfront testing costs. However, early detection of FGFR3-positive patients facilitated timely initiation of second-line targeted therapy (erdafitinib), which is administered in outpatient settings and reimbursed through social insurance. Consequently, routine FGFR3 testing did not significantly increase long-term overall hospital expenditure. The average hospital lifetime cost per mUC patient with FGFR3 testing was €154,701, €2,501 (1.6%) lower compared to no testing. Over five years, routine FGFR3 testing could achieve hospital savings of €127,562 (1.6%) for a hospital treating 10 mUC patients annually. Sensitivity analyses indicated key parameters influencing the results, notably FGFR3 test costs, FGFR3 alteration prevalence and hospital drug prices.
CONCLUSIONS: This analysis suggests that the long-term financial implications of 1L FGFR3 testing and targeted treatment can offset the initial costs associated with testing. These findings may reassure hospital management regarding financial feasibility and support the adoption of FGFR3 testing in mUC clinical practice.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE83
Topic
Economic Evaluation, Medical Technologies, Organizational Practices
Topic Subcategory
Budget Impact Analysis
Disease
Oncology