Next-generation sequencing in NSCLC and melanoma patients: a cost and budget impact analysis

Abstract

Next-generation sequencing (NGS) has reached the molecular diagnostic laboratories. Although the NGS technology aims to improve the effectiveness of therapies by selecting the most promising therapy, concerns are that NGS testing is expensive and that the ‘benefits’ are not yet in relation to these costs. In this study, we give an estimation of the costs and an institutional and national budget impact of various types of NGS tests in non-small-cell lung cancer (NSCLC) and melanoma patients within The Netherlands. First, an activity-based costing (ABC) analysis has been conducted on the costs of two examples of NGS panels (small- and medium-targeted gene panel (TGP)) based on data of The Netherlands Cancer Institute (NKI). Second, we performed a budget impact analysis (BIA) to estimate the current (2015) and future (2020) budget impact of NGS on molecular diagnostics for NSCLC and melanoma patients in The Netherlands. Literature, expert opinions, and a data set of patients within the NKI (n = 172) have been included in the BIA. Based on our analysis, we expect that the NGS test cost concerns will be limited. In the current situation, NGS can indeed result in higher diagnostic test costs, which is mainly related to required additional tests besides the small TGP. However, in the future, we expect that the use of whole-genome sequencing (WGS) will increase, for which it is expected that additional tests can be (partly) avoided. Although the current clinical benefits are expected to be limited, the research potentials of NGS are already an important advantage.

Application of next‐generation sequencing to improve cancer management: A review of the clinical effectiveness and cost‐effectiveness

“…On average, the cost of targeted gene panel sequencing per sample was found to be US $1609 (range: US$488-US$3443). Cost of sequencing is generally lower if it is performed in-house [25][26][27] compared to outsourcing to a service provider. [28][29][30]32 Two articles reported cost of WES and RNAseq.…”

Micro-costing Diagnostics in Oncology: From Single-Gene Testing to Whole Genome Sequencing

“…Single-gene analysis or sequencing of targeted gene panels (TGP) using next generation sequencing (NGS) techniques, or a combination of the two, are routine practice in the diagnostics trajectory for different cancer types (11). In current clinical practice, there is large variation in both the frequency and type of technique used for the selection of cancer treatment (12). In comparison, the advanced diagnostic technique of whole genome sequencing (WGS) is currently only applied in research context in oncology.…”

A DNA-modified hydrogel for simultaneous purification, concentration and detection of targeted cfDNA in human serum

“…11,12 However, all these methods are limited by the need for specialized equipment and stringent laboratory conditions, resulting in exorbitant costs. 13,14 Therefore, signicant interest is being focused on the development of a simple, economical, and effective strategy for the purication, concentration, and detection of cfDNA.…”