Cost-comparison analysis of a multiplatform tumour profiling service to guide advanced cancer treatment

Gilbert Spizzo,Robert Leonard,Klaus Schuster,Guenther Gastl,Uwe Siebert,Andreas Voss,Andreas Seeber

doi:10.1186/s12962-019-0191-6

Abstract

BackgroundTumor profiling is increasingly used in advanced cancer patients to define treatment options, especially in refractory cases where no standard treatment is available. Caris Molecular Intelligence (CMI) is a multiplatform tumor profiling service that is comprehensive of next-generation sequencing (NGS) of DNA and RNA, immunohistochemistry (IHC) and in situ hybridisation (FISH). The aim of this study is to compare costs of CMI-guided treatment with prior or planned treatment options in correlation with outcome results.MethodsRetrospective data from five clinical trials were collected to define the treatment decision prior to the receipt of the CMI report (n = 137 patients). A systematic review of treatment data from 11 clinical studies of CMI (n = 385 patients) allowed a comparison of planned vs actual (n = 137) and prior vs actual (n = 229) treatment costs.ResultsTreatment plan was changed in 88% of CMI-profiled cases. The actual CMI guided treatment cost per cycle was £995 in 385 treated patients. Planned treatment costs were comparable to actual treatment costs (£979 vs £945; p = 0.7123) and prior treatment costs were not significantly different to profiling-guided treatments (£892 vs £850; p = 0.631).ConclusionsCaris Molecular Intelligence guided treatment cost per cycle was in the range of prior or planned treatment cost/cycle. Due to beneficial overall survival the additional cost of performing CMI’s multiplatform testing to the treatment costs seems to be cost-effective.

Highlights

Tumor profiling is increasingly used in advanced cancer patients to define treatment options, especially in refractory cases where no standard treatment is available
Tumour profiling in oncology involves the use of high throughput technologies such as next-generation sequencing (NGS) of DNA and/or RNA, immunohistochemistry (IHC) and in situ hybridization (FISH) beside others
Recent data showing the health-economic impact of molecular profiling has focused on incremental increases in progression-free survival (PFS), total costs and cost per week of survival associated with profiling-guided therapies [3]

Summary

Introduction

Tumor profiling is increasingly used in advanced cancer patients to define treatment options, especially in refractory cases where no standard treatment is available. Caris Molecular Intelligence (CMI) is a multiplatform tumor profiling service that is comprehensive of next-generation sequencing (NGS) of DNA and RNA, immunohistochemistry (IHC) and in situ hybridisation (FISH). Tumour profiling in oncology involves the use of high throughput technologies such as next-generation sequencing (NGS) of DNA and/or RNA, immunohistochemistry (IHC) and in situ hybridization (FISH) beside others. These techniques are being used as precision tools to predict which treatments may be beneficial for an individual patient or potentially lack benefit. Recent data showing the health-economic impact of molecular profiling has focused on incremental increases in progression-free survival (PFS), total costs and cost per week of survival associated with profiling-guided therapies [3]

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