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.

de Alava, EnriquePareja, María JesúsCarcedo, DavidArrabal, NataliaGarcía, José-FranciscoBernabé-Caro, Reyes2023-05-032023-05-032022-05-25http://hdl.handle.net/10668/19681To 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.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Non-small cell lung cancer (NSCLC)cost-effectivenessmolecular profilingnext-generation sequencingoncogenic driverssequential single testingCarcinoma, Non-Small-Cell LungCost-Benefit AnalysisHigh-Throughput Nucleotide SequencingHospitalsHumansLung NeoplasmsMutationCost-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.research article35593180open access10.1080/14737167.2022.20783101744-8379https://www.tandfonline.com/doi/pdf/10.1080/14737167.2022.2078310?needAccess=true