Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non-Small-Cell Lung Cancer From the Perspective of Spanish Reference Centers

PURPOSE The aim of this study was to assess the cost-effectiveness of using next-generation sequencing (NGS) versus single-gene testing (SgT) for the detection of genetic molecular subtypes and oncogenic markers in patients with advanced non-small-cell lung cancer (NSCLC) in the setting of Spanish r...

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Autores: Arriola, E., Bernabé, R., García Campelo, María del Rosario, Biscuola, M., Enguita, A.B., López-Ríos, F., Martínez, R., Mezquita, L., Palanca, S., Pareja, M.J., Zugazagoitia, J., Arrabal, N., García, J.F., Carcedo, D., de Álava, E.
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Servizo Galego de Saúde (SERGAS)
Repositorio:RUNA. Repositorio da Consellería de Sanidade e Sergas
OAI Identifier:oai:runa.sergas.gal:20.500.11940/21281
Acceso en línea:https://portalcientifico.sergas.gal//documentos/673a62f610dcc339fb2b2e51
http://hdl.handle.net/20.500.11940/21281
Access Level:acceso abierto
Palabra clave:Humans
Carcinoma, Non-Small-Cell Lung
Cost-Benefit Analysis
Lung Neoplasms
High-Throughput Nucleotide Sequencing
Genetic Testing
AS A Coruña
CHUAC
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spelling Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non-Small-Cell Lung Cancer From the Perspective of Spanish Reference CentersArriola, E.Bernabé, R.García Campelo, María del RosarioBiscuola, M.Enguita, A.B.López-Ríos, F.Martínez, R.Mezquita, L.Palanca, S.Pareja, M.J.Zugazagoitia, J.Arrabal, N.García, J.F.Carcedo, D.de Álava, E.HumansCarcinoma, Non-Small-Cell LungCost-Benefit AnalysisLung NeoplasmsHigh-Throughput Nucleotide SequencingGenetic TestingAS A CoruñaCHUACPURPOSE The aim of this study was to assess the cost-effectiveness of using next-generation sequencing (NGS) versus single-gene testing (SgT) for the detection of genetic molecular subtypes and oncogenic markers in patients with advanced non-small-cell lung cancer (NSCLC) in the setting of Spanish reference centers. METHODS A joint model combining decision tree with partitioned survival models was developed. A two-round consensus panel was performed to describe clinical practice of Spanish reference centers, providing data on testing rate, prevalence of alterations, turnaround times, and treatment pathways. Treatment efficacy data and utility values were obtained from the literature. Only direct costs (euros, 2022), obtained from Spanish databases, were included. A lifetime horizon was considered, so a 3% discount rate for future costs and outcomes was considered. Both deterministic and probabilistic sensitivity analyses were performed to assess uncertainty. RESULTS A target population of 9, 734 patients with advanced NSCLC was estimated. If NGS was used instead of SgT, 1, 873 more alterations would be detected and 82 more patients could potentially be enrolled in clinical trials. In the long term, using NGS would provide 1, 188 additional quality-adjusted life-years (QALYs) in the target population compared with SgT. On the other hand, the incremental cost of NGS versus SgT in the target population was V21, 048, 580 euros for a lifetime horizon (V1, 333, 288 for diagnosis phase only). The obtained incremental cost-utility ratios were V25, 895 per QALY gained, below the standard cost-effectiveness thresholds. CONCLUSION Using NGS in Spanish reference centers for the molecular diagnosis of patients with metastatic NSCLC would be a cost-effective strategy over SgT.Supported by Roche Farma SA Roche Farma SA. played no role in the design of the study; collection, analysis, and interpretation of data; and writing the manuscript.2023info:eu-repo/semantics/articlehttps://portalcientifico.sergas.gal//documentos/673a62f610dcc339fb2b2e51http://hdl.handle.net/20.500.11940/21281reponame:RUNA. Repositorio da Consellería de Sanidade e Sergasinstname:Servizo Galego de Saúde (SERGAS)Ingléshttps://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:runa.sergas.gal:20.500.11940/212812026-06-12T08:40:47Z
dc.title.none.fl_str_mv Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non-Small-Cell Lung Cancer From the Perspective of Spanish Reference Centers
title Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non-Small-Cell Lung Cancer From the Perspective of Spanish Reference Centers
spellingShingle Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non-Small-Cell Lung Cancer From the Perspective of Spanish Reference Centers
Arriola, E.
Humans
Carcinoma, Non-Small-Cell Lung
Cost-Benefit Analysis
Lung Neoplasms
High-Throughput Nucleotide Sequencing
Genetic Testing
AS A Coruña
CHUAC
title_short Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non-Small-Cell Lung Cancer From the Perspective of Spanish Reference Centers
title_full Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non-Small-Cell Lung Cancer From the Perspective of Spanish Reference Centers
title_fullStr Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non-Small-Cell Lung Cancer From the Perspective of Spanish Reference Centers
title_full_unstemmed Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non-Small-Cell Lung Cancer From the Perspective of Spanish Reference Centers
title_sort Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non-Small-Cell Lung Cancer From the Perspective of Spanish Reference Centers
dc.creator.none.fl_str_mv Arriola, E.
Bernabé, R.
García Campelo, María del Rosario
Biscuola, M.
Enguita, A.B.
López-Ríos, F.
Martínez, R.
Mezquita, L.
Palanca, S.
Pareja, M.J.
Zugazagoitia, J.
Arrabal, N.
García, J.F.
Carcedo, D.
de Álava, E.
author Arriola, E.
author_facet Arriola, E.
Bernabé, R.
García Campelo, María del Rosario
Biscuola, M.
Enguita, A.B.
López-Ríos, F.
Martínez, R.
Mezquita, L.
Palanca, S.
Pareja, M.J.
Zugazagoitia, J.
Arrabal, N.
García, J.F.
Carcedo, D.
de Álava, E.
author_role author
author2 Bernabé, R.
García Campelo, María del Rosario
Biscuola, M.
Enguita, A.B.
López-Ríos, F.
Martínez, R.
Mezquita, L.
Palanca, S.
Pareja, M.J.
Zugazagoitia, J.
Arrabal, N.
García, J.F.
Carcedo, D.
de Álava, E.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Humans
Carcinoma, Non-Small-Cell Lung
Cost-Benefit Analysis
Lung Neoplasms
High-Throughput Nucleotide Sequencing
Genetic Testing
AS A Coruña
CHUAC
topic Humans
Carcinoma, Non-Small-Cell Lung
Cost-Benefit Analysis
Lung Neoplasms
High-Throughput Nucleotide Sequencing
Genetic Testing
AS A Coruña
CHUAC
description PURPOSE The aim of this study was to assess the cost-effectiveness of using next-generation sequencing (NGS) versus single-gene testing (SgT) for the detection of genetic molecular subtypes and oncogenic markers in patients with advanced non-small-cell lung cancer (NSCLC) in the setting of Spanish reference centers. METHODS A joint model combining decision tree with partitioned survival models was developed. A two-round consensus panel was performed to describe clinical practice of Spanish reference centers, providing data on testing rate, prevalence of alterations, turnaround times, and treatment pathways. Treatment efficacy data and utility values were obtained from the literature. Only direct costs (euros, 2022), obtained from Spanish databases, were included. A lifetime horizon was considered, so a 3% discount rate for future costs and outcomes was considered. Both deterministic and probabilistic sensitivity analyses were performed to assess uncertainty. RESULTS A target population of 9, 734 patients with advanced NSCLC was estimated. If NGS was used instead of SgT, 1, 873 more alterations would be detected and 82 more patients could potentially be enrolled in clinical trials. In the long term, using NGS would provide 1, 188 additional quality-adjusted life-years (QALYs) in the target population compared with SgT. On the other hand, the incremental cost of NGS versus SgT in the target population was V21, 048, 580 euros for a lifetime horizon (V1, 333, 288 for diagnosis phase only). The obtained incremental cost-utility ratios were V25, 895 per QALY gained, below the standard cost-effectiveness thresholds. CONCLUSION Using NGS in Spanish reference centers for the molecular diagnosis of patients with metastatic NSCLC would be a cost-effective strategy over SgT.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://portalcientifico.sergas.gal//documentos/673a62f610dcc339fb2b2e51
http://hdl.handle.net/20.500.11940/21281
url https://portalcientifico.sergas.gal//documentos/673a62f610dcc339fb2b2e51
http://hdl.handle.net/20.500.11940/21281
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:RUNA. Repositorio da Consellería de Sanidade e Sergas
instname:Servizo Galego de Saúde (SERGAS)
instname_str Servizo Galego de Saúde (SERGAS)
reponame_str RUNA. Repositorio da Consellería de Sanidade e Sergas
collection RUNA. Repositorio da Consellería de Sanidade e Sergas
repository.name.fl_str_mv
repository.mail.fl_str_mv
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