OBJECTIVES

: Molecular profiling of cancers to support treatment planning has become a new standard of care for many patients with advanced and metastatic solid tumors. There are still questions around the clinical utility, the best use of results in real life treatment decisions, and implications on overall costs due to the scope of various commercial services.This research examines the impact of molecular tumor profiling on treatment selection and costs from a perspective of the Health Authorities in the UAE.

METHODS

: List price data from the UAE and published studies were analyzed for changes in treatment decisions after the molecular profiling results became available to the treating oncologists. The costs of molecular guided treatments were compared to those of the originally planned treatments.

RESULTS

: Data from 5 physician led studies and list price data from the UAE were analyzed. The actual costs of drugs (list prices) in Dubai were used to calculate average costs of planned treatments (n=137) and actually administered treatments (n=137). We also collected information on the last treatment regimen (n=229) before molecular profiling and compared the costs with guided treatment after profiling (n=229).

We found that molecular profiling changed treatment decisions for a significant part of the profiled patients (19% to 88%) and also treatment costs (-8.8% to +252%) depending on the underlying disease, the profiling service used and the disease stage at which molecular profiling was performed.

CONCLUSIONS

: Guided treatments based on next generation sequencing data alone are more expensive than those based on multiplatform molecular profiling (+252%). Comprehensive molecular profiling leads to a change in treatments for most patients with advanced and refractory cancer and can reduce spending for treatments (-8.8%).