Cost-Effectiveness and Budget Impact of Future Developments With Whole-Genome Sequencing for Patients With Lung Cancer

Jan 1, 2023, 00:00 AM
10.1016/j.jval.2022.07.006
https://www.valueinhealthjournal.com/article/S1098-3015(22)02102-7/fulltext
Section Title : ECONOMIC EVALUATION
Section Order : 71
First Page : 71

Objectives

This study aimed to investigate the cost-effectiveness, budget impact (BI), and impact of uncertainty of future developments concerning whole-genome sequencing (WGS) as a clinical diagnostic test compared with standard of care (SoC) in patients with locally advanced and metastatic non–small cell lung cancer.

Methods

A total of 3 likely scenarios to take place within 5 years (according to experts) were simulated using a previously developed, peer reviewed, and published decision model. The scenarios concerned “WGS results used for treatment selection” (scenario 1), “WGS-based biomarker for immunotherapy” (scenario 2), and “off-label drug approval for WGS results” (scenario 3). Two diagnostic strategies of the original model, “SoC” and “WGS as a diagnostic test” (base model), were used to compare our scenarios with. Outcomes were reported for the base model, all scenarios separately, combined (combined unweighted), and weighted by likelihood (combined weighted). Cost-effectiveness, BI, and value of information analyses were performed for WGS compared with SoC.

Results

Total costs and quality-adjusted life-years for SoC in metastatic non–small cell lung cancer were €149 698 and 1.235. Incremental outcomes of WGS were €1529/0.002(base model), −€222/0.020(scenario 1), −€2576/0.023(scenario 2), €388/0.024(scenario 3), −€5041/0.060(combined unweighted), and −€1715/0.029(combined weighted). The annual BI for adopting WGS for this population in The Netherlands ranged between €682 million (combined unweighted) and €714 million (base model). The consequences of uncertainty amounted to €3.4 million for all scenarios (combined weighted) and to €699 000 for the diagnostic yield of WGS alone (combined weighted).

Conclusions

Our findings suggest that it is likely for WGS to become cost-effective within the near future if it identifies more patients with actionable targets and show the impact of uncertainty regarding its diagnostic yield. Modeling future scenarios can be useful to consider early adoption of WGS while timely anticipating on unforeseen developments before final conclusions are reached.

https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(22)02102-7&doi=10.1016/j.jval.2022.07.006
HEOR Topics :
  • Budget Impact Analysis
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Decision Modeling & Simulation
  • Economic Evaluation
  • Oncology
  • Specific Diseases & Conditions
  • Study Approaches
  • Value of Information
Tags :
  • budget impact
  • cost-effectiveness
  • decision analytic model
  • future scenarios
  • implementation
  • molecular diagnostics
  • value of information
  • whole-genome sequencing
Regions :
  • Western Europe