OR31 The economics of next generation sequencing

Abstract

Aim For many clinical labs the scientific benefit of generating whole gene consensus sequences, the 3-field or higher resolution of the typing method and the ability to batch very large numbers of samples may not be sufficiently compelling to make the decision to switch to NGS. However, for small and large labs, the economics of adopting NGS are undeniably favorable in the long run after a moderate investment in capital equipment. In this study we take a Key Opinion Leader (KOL) focused approach to demonstrate the economic benefits of adopting NGS for HLA genotyping in clinical routine from multiple customer sites. Methods We used 24 samples per week as an example of a low-medium throughput laboratory. We used 96 samples per week as an example of a high throughput laboratory. We compared the costs from multiple customer sites in multiple geographic locations to determine reasonable averages for the costs associated with each of the HLA genotyping techniques. Results In the comparison between SSO, SBT and NGS we observe that the costs associated with increasing the number of loci tested by NGS doesn’t scale linearly, but reduces the cost per locus with each additional locus. Similarly, with increasing numbers of samples from 24 to 96 also sees a reduction in cost per sample (and by extension cost per locus). Conclusion Here we demonstrate that compared to legacy technologies, NGS of whole genes has less reflexive testing, less results interpretation, lower hands on time, lower reagent costs than SBT. Similarly, at large volumes and for 11 loci, NGS is cost competitive with SSO thus suggesting a single technology can perfectly support both SOT and BMT workflows. Finally, with high resolution typings for DRB3/4/5 against which antibodies may be raised post-transplant, the reflexive determinations of these types during post-transplant monitoring will not be required further reducing overall costs.