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    Appraising the costs of genomic testing for histology-independent technologies: an illustrative example for NTRK fusions

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    Authors
    Beresford, L.
    Murphy, P.
    Dias, S.
    Claxton, L.
    Walton, M.
    Metcalf, Robert
    Schlecht, H.
    Ottensmeier, C.
    Pereira, M.
    Hodgson, R.
    Affiliation
    Centre for Reviews and Dissemination, University of York, York, England, UK
    Issue Date
    2022
    
    Metadata
    Show full item record
    Abstract
    Objectives: Histology-independent (HI) technologies are authorized for patients with advanced or metastatic cancer if they express a particular biomarker regardless of its position in the body. Although this represents an important advancement in cancer treatment, genomic testing to identify eligible individuals for HI technologies will require substantial investment and impact their cost-effectiveness. Estimating these costs is complicated by several issues, which affect not only the overall cost of testing but also the distribution of testing costs across tumor types. Methods: Key issues that should be considered when evaluating the cost of genomic testing to identify those eligible for HI technologies are discussed. These issues are explored in illustrative analyses where costs of genomic testing for NTRK fusions in England for recently approved HI technologies are estimated. Results: The prevalence of mutation, testing strategy adopted, and current testing provision affect the cost of identifying eligible patients. The illustrative analysis estimated the cost of RNA-based next-generation sequencing to identify 1 individual with an NTRK fusion ranged between £377 and £282 258. To improve cost-effectiveness, testing costs could be shared across multiple technologies. An estimated additional ∼4000 patients would need to be treated with other HI therapies for testing in patients with advanced or metastatic cancer to be cost-effective. Conclusions: The cost of testing to identify individuals eligible for HI technologies affect the drug's cost-effectiveness. The cost of testing across tumor types varies owing to heterogeneity in the mutation's prevalence and current testing provision. The cost-effectiveness of HI technologies may be improved if testing costs could be shared across multiple agents.
    Citation
    Beresford L, Murphy P, Dias S, Claxton L, Walton M, Metcalf R, et al. Appraising the Costs of Genomic Testing for Histology-Independent Technologies: An Illustrative Example for NTRK Fusions. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. 2022 Jul;25(7):1133-40. PubMed PMID: 35779940. Epub 2022/07/03. eng.
    Journal
    Value Health
    URI
    http://hdl.handle.net/10541/625410
    DOI
    10.1016/j.jval.2021.11.1359
    PubMed ID
    35779940
    Additional Links
    https://dx.doi.org/10.1016/j.jval.2021.11.1359
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jval.2021.11.1359
    Scopus Count
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