METHODS: Articles relevant to the objectives were chosen through key terms such as cancer/malignancy, next generation sequencing versus high-throughput sequencing, and cost/cost-benefit/cost-effectiveness analysis. Costs included direct and indirect costs of the sequencing methods, and downstream costs such as treatment price. The review was based on the incremental cost-effectiveness ratio (ICER). Databases were screened for research articles with European data evaluating the cost-effectiveness of NGS and other HTS. Due to the rapid development of sequencing technology, our search was limited to articles that were published in the last five years (since 2015).

RESULTS: The data regarding NGS and subsequent treatment cost-effectiveness is limited and conflicting with some studies showing that NGS is cost-effective, while others reveal the opposite. Reported ICER in terms of NGS followed by targeted therapy is not affected much by sequencing costs and is affected by treatment choice and benefit instead.

CONCLUSIONS: The high-throughput nature of NGS produces better clinical results due to the improved targeting of therapies compared to HTS. However, the costs of NGS vary in different countries, and there is a growing need for economic analysis that facilitates decision-making processes regarding the use of diagnostic tools. Moreover, the varying costs of treatments across countries warrant local economic analyses of NGS in conjunction with targeted treatment.