首页 | 本学科首页   官方微博 | 高级检索  
     


Cost-Effectiveness and Budget Impact of Future Developments With Whole-Genome Sequencing for Patients With Lung Cancer
Affiliation:1. Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands;2. Care And Public Health Research Institute, Maastricht University, Maastricht, The Netherlands;3. Erasmus School of Health Policy and Management/Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands;4. Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands;5. Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands;6. Department of Pulmonary Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
Abstract:ObjectivesThis 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.MethodsA 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.ResultsTotal 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).ConclusionsOur 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.
Keywords:budget impact  cost-effectiveness  decision analytic model  future scenarios  implementation  molecular diagnostics  value of information  whole-genome sequencing
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号