Cost-Effectiveness of Multi-Gene Panel Testing for Patients With Advanced Non-Small Cell Lung Cancer

According to a study using real-world data, it is likely that using multi-gene panel sequencing to inform targeted treatment for patients with non-small cell lung cancer (NSCLC) would be cost-effective at great willingness-to-pay thresholds.

While multi-gene panel sequencing can inform treatment selection for patients with advanced NSCLC, “implementation continues to be uneven across jurisdictions,” study authors noted, “partly due to uncertain clinical and economic impacts.” They added that “multi-gene panels have the potential of being cost- and time-effective by reducing the need for sequential single-gene testing, which may be linked to additional biopsies resulting in increased costs, patient burden, and lengthening diagnostic timelines.”

This population-based, retrospective study evaluated the cost-effectiveness of multigene panels as reimbursed by the public healthcare system of British Columbia, Canada. There were 858 patients who received multi-gene panel sequencing were matched to control receiving single-gene testing. The 3-year survival time and costs were estimated, and incremental net monetary benefit for life-years gained was then calculated at conventional willingness-to-pay thresholds.

The average turnaround times for multi-gene panel sequencing was 18.6 days, compared to 7.0 days for single-gene testing. After matching the mean incremental costs were $3529 and the mean incremental life-years gained was 0.08. Study authors also noted they found “multi-gene panel sequencing alone does not result in statistically significant survival differences or changes in cost.” The incremental net monetary benefit was $523, at $50,000 per life-year gained and %4575 at $100,000 per life-year gained. This came to a 57.5% and a 84.0% probability of being cost-effective, respectively.

Study authors concluded, there was a “high probability that panel-based testing would be cost-effective at higher thresholds even with differences in survival and costs that were not statistically significant compared to single-gene testing.” They added that their results indicated “the cost-effectiveness of multi-gene panel sequencing was not primarily influenced by the sequencing cost alone.”

Source:

Krebs E, Weymann D, Ho C, et al. Real-world cost-effectiveness of multi-gene panel sequencing to inform therapeutic decisions for advanced non-small cell lung cancer: A population-based study. Lancet Reg Health. Published online November 15, 2024. doi:10.1016/j.lana.2024.100936