ASCO 2018 Preview: Economic Impact of Genomic Testing Options in Metastatic NSCLC
Posted: Friday, May 18, 2018
Upfront next-generation sequencing (NGS) appears to be the least expensive option when testing newly diagnosed patients with metastatic non–small cell lung cancer (NSCLC) for genomic alterations to inform treatment decisions, according to an economic impact study led by Nathan Pennell, MD, PhD, of the Cleveland Clinic in Cleveland, Ohio. In addition, NGS also had the same wait time as panel testing and a shorter wait time than exclusionary and sequential testing.
The study, which will be presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago (Abstract 9031), was designed to assess the financial impact of NGS versus sequential single-gene testing modalities for the Center for Medicare and Medicaid Services (CMS) and commercial payers in the United States.
With a decision analytic model, newly diagnosed patients with metastatic NSCLC were modeled to receive PD-L1 and genomic alteration tests (EGFR, ALK, ROS1, BRAF, MET, HER2, RET, NTRK1) using one of the following: sequential tests, exclusionary mutation (KRAS) test followed by sequential tests, panel test, or upfront NGS.
For hypothetical 1 million-member plans, 2,066 CMS Medicare and 156 commercially insured patients with metastatic NSCLC would be tested for genomic alterations. The investigators estimated that for CMS reimbursement, NGS represented savings of $1.39 million versus exclusionary testing, $1.53 million versus sequential testing, and $2.14 million versus panel testing. NGS was also the least expensive for commercial payers. The estimated time to receive results was 2.0 weeks for NGS and panel testing—2.7 and 2.8 weeks faster than both exclusionary and sequential testing, respectively.
“It’s encouraging to see that next-generation genetic testing tools can help physicians and their patients get the crucial genomic information they need to make treatment decisions, at a faster pace and lower cost than with other approaches,” stated ASCO President Bruce E. Johnson, MD, FASCO, in an ASCO press release.
