Health and Budget Impact of Liquid-Biopsy-Based Comprehensive Genomic Profile (CGP) Testing in Tissue-Limited Advanced Non-Small Cell Lung Cancer (aNSCLC) Patients |
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Authors: | Yuti P. Patel Donald Husereau Natasha B. Leighl Barbara Melosky Julian Nam |
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Affiliation: | 1.Hoffmann-La Roche Ltd., Mississauga, ON L5N 5M8, Canada;2.School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada;3.Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada;4.British Columbia Cancer Agency, Vancouver, BC V5Z 4E6, Canada;5.Hoffmann-La Roche Ltd., Grenzacherstrasse 124, Bldg 1/Floor 12, CH-4070 Basel, Switzerland; |
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Abstract: | BACKGROUND AND OBJECTIVES: Molecular genetic testing using tissue biopsies can be challenging for patients due to unfavorable tumor sites, the invasive nature of a tissue biopsy, and the added time of booking a repeat biopsy (re-biopsy). Centers in Canada have found insufficient tissue rates to be approximately 10%, and even among successful biopsies, insufficient DNA in tissue samples is approximately 16%, triggering the lengthy process of re-biopsies. Using aNSCLC as an example, this study sought to characterize the health and budget impact of alternative liquid-biopsy(LBx)-based comprehensive genomic profile (CGP) testing in tissue-limited patients (TL-LBx-CGP) from a Canadian publicly funded healthcare perspective. MATERIAL AND METHODS: An economic model was developed to estimate the incremental cost and life-years gained as a population associated with adopting TL-LBx-CGP. The eligible patient population was modeled using a top-down epidemiological approach based on the published literature and expert clinician input. Treatment allocation was modeled based on biomarker prevalence in the published literature, and the availability of funded therapies. Costs included molecular testing, as well as drug, administrative, and supportive costs, and relevant health data included median overall survival and median progression-free survival data. RESULTS: Incorporation of TL-LBx-CGP demonstrated an overall impact of $14.7 million with 168 life-years gained to the Canadian publicly funded healthcare system in the 3-year time horizon. |
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Keywords: | liquid biopsy comprehensive genomic profiling tissue-limited health and budget impact non-small cell lung cancer next generation sequencing single-gene testing Canadian public payers |
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