Publication: Cost-effectiveness analysis of molecular diagnosis by next-generation sequencing versus sequential single testing in metastatic non-small cell lung cancer patients from a south Spanish hospital perspective.
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Identifiers
Date
2022-05-25
Authors
de-Alava, Enrique
Pareja, Maria Jesus
Carcedo, David
Arrabal, Natalia
Garcia, Jose-Francisco
Bernabe-Caro, Reyes
Advisors
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor & Francis
Abstract
To assess the cost-effectiveness of using next-generation sequencing (NGS) compared to sequential single-testing (SST) for molecular diagnostic and treatment of patients with advanced non-small cell lung cancer (NSCLC) from a Spanish single-center perspective, the Hospital Universitario Virgen del Rocio (HUVR). A decision-tree model was developed to assess the alterations detection alterations and diagnostic cost in patients with advanced NSCLC, comparing NGS versus SST. Model inputs such as testing, positivity rates, or treatment allocation were obtained from the literature and the clinical practice of HUVR experts through consultation. Several sensitivity analyses were performed to test the robustness of the model. Using NGS for molecular diagnosis of a 100-patients hypothetical cohort, 30 more alterations could be detected and 3 more patients could be enrolled in clinical-trials than using SST. On the other hand, diagnostic costs were increased up to €20,072 using NGS instead of SST. Using NGS time-to-results would be reduced from 16.7 to 9 days. The implementation of NGS at HUVR for the diagnostic of patients with advanced NSCLC provides significant clinical benefits compared to SST in terms of alterations detected, treatment with targeted-therapies and clinical-trial enrollment, and could be considered a cost-effective strategy.
Description
MeSH Terms
Carcinoma, Non-Small-Cell Lung
Cost-Benefit Analysis
High-Throughput Nucleotide Sequencing
Hospitals
Humans
Lung Neoplasms
Mutation
Cost-Benefit Analysis
High-Throughput Nucleotide Sequencing
Hospitals
Humans
Lung Neoplasms
Mutation
DeCS Terms
Pacientes
Terapéutica
Diagnóstico
Carcinoma de pulmón de células no Pequeñas
Patología molecular
Secuenciación de nucleótidos de alto rendimiento
Mano
Terapéutica
Diagnóstico
Carcinoma de pulmón de células no Pequeñas
Patología molecular
Secuenciación de nucleótidos de alto rendimiento
Mano
CIE Terms
Keywords
Non-small cell lung cancer (NSCLC), cost-effectiveness, molecular profiling, next-generation sequencing, oncogenic drivers, sequential single testing
Citation
de Alava E, Pareja MJ, Carcedo D, Arrabal N, García JF, Bernabé-Caro R. Cost-effectiveness analysis of molecular diagnosis by next-generation sequencing versus sequential single testing in metastatic non-small cell lung cancer patients from a south Spanish hospital perspective. Expert Rev Pharmacoecon Outcomes Res. 2022 Sep;22(6):1033-1042.