Costs of biomarker testing in advanced non‐small cell lung cancer: a global study comparing next‐generation sequencing and single‐gene testing

Current European/US guidelines recommend that molecular testing in advanced non-small cell lung cancer (aNSCLC) be performed using next-generation sequencing (NGS). However, the global uptake of NGS is limited, largely owing to reimbursement constraints. We compared real-world costs of NGS and single-gene testing (SGT) in nonsquamous aNSCLC. This observational study was conducted across 10 pathology centers in 10 different countries worldwide. Biomarker data collected via structured questionnaires (1 January-31 December 2021) were used to feed micro-costing analyses for three scenarios ['Starting Point' (SP; 2021-2022), 'Current Practice' (CP; 2023-2024), and 'Future Horizons' (FH; 2025-2028)] in both a real-world model, comprising all biomarkers tested by each center, and a standardized model, comprising the same sets of biomarkers across centers. Testing costs (including retesting) encompassed personnel costs, consumables, equipment, and overheads. Overall, 4,491 patients with aNSCLC were evaluated. Mean per-patient costs decreased for NGS relative to SGT over time, with real-world model costs 18% lower for NGS than for SGT in the SP scenario, and 26% lower for NGS than for SGT in the CP scenario. Mean per-biomarker costs also decreased over time for NGS relative to SGT. In the standardized model, the tipping point for the minimum number of biomarkers required for NGS to result in cost savings (per patient) was 10 and 12 in the SP and CP scenarios, respectively. Retesting had a negligible impact on cost analyses, and results were robust to variation in cost parameters. This study provides robust real-world global evidence for cost savings with NGS-based panels over SGT to evaluate predictive biomarkers in nonsquamous aNSCLC when the number of biomarkers to be tested exceeds 10. Widespread adoption of NGS may enable more efficient use of limited healthcare resources.

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Publication Details

Journal
The Journal of Pathology Clinical Research
Published
2025-03-01
DOI
https://doi.org/10.1002/2056-4538.70018
Citations
3
Primary Topic
Cancer Genomics and Diagnostics
Type
article
Field-Weighted Citation Impact
2.81

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article

Costs of biomarker testing in advanced non‐small cell lung cancer: a global study comparing next‐generation sequencing and single‐gene testing

Charles‐Hugo Marquette, Andromachi Giannopoulou, Umberto Malapelle, Ed Schuuring et al.
3 citations
The Journal of Pathology Clinical Research
Cancer Genomics and Diagnostics
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article

Costs of biomarker testing in advanced non‐small cell lung cancer: a global study comparing next‐generation sequencing and single‐gene testing

Charles‐Hugo Marquette, Andromachi Giannopoulou, Umberto Malapelle, Ed Schuuring, Joshua Kapp, Albrecht Stenzinger, Yi‐Lin Chen, Giancarlo Troncone, Enrique de Álava, Arja ter Elst, Maria Michelli, Tae Jung Kim, Sebastian Gonzalez‐McQuire, Chien‐Chin Chen, Michele Biscuola, Daniel Kazdal, Angelica A. Saetta, Hana Vošmiková, Aleš Ryška, Paul Hofman, Anna Baggi, Tony Kiat Hon Lim, Jean Marie Franzini, Gek San Tan, Victoria Lucia Rabsiun Aramburu
article en
3 citations

Abstract

Current European/US guidelines recommend that molecular testing in advanced non-small cell lung cancer (aNSCLC) be performed using next-generation sequencing (NGS). However, the global uptake of NGS is limited, largely owing to reimbursement constraints. We compared real-world costs of NGS and single-gene testing (SGT) in nonsquamous aNSCLC. This observational study was conducted across 10 pathology centers in 10 different countries worldwide. Biomarker data collected via structured questionnaires (1 January-31 December 2021) were used to feed micro-costing analyses for three scenarios ['Starting Point' (SP; 2021-2022), 'Current Practice' (CP; 2023-2024), and 'Future Horizons' (FH; 2025-2028)] in both a real-world model, comprising all biomarkers tested by each center, and a standardized model, comprising the same sets of biomarkers across centers. Testing costs (including retesting) encompassed personnel costs, consumables, equipment, and overheads. Overall, 4,491 patients with aNSCLC were evaluated. Mean per-patient costs decreased for NGS relative to SGT over time, with real-world model costs 18% lower for NGS than for SGT in the SP scenario, and 26% lower for NGS than for SGT in the CP scenario. Mean per-biomarker costs also decreased over time for NGS relative to SGT. In the standardized model, the tipping point for the minimum number of biomarkers required for NGS to result in cost savings (per patient) was 10 and 12 in the SP and CP scenarios, respectively. Retesting had a negligible impact on cost analyses, and results were robust to variation in cost parameters. This study provides robust real-world global evidence for cost savings with NGS-based panels over SGT to evaluate predictive biomarkers in nonsquamous aNSCLC when the number of biomarkers to be tested exceeds 10. Widespread adoption of NGS may enable more efficient use of limited healthcare resources.

The Journal of Pathology Clinical ResearchVol. 11(2)
University Medical Center Groningen (NL), University of Groningen (NL), National and Kapodistrian University of Athens (GR), Charles University (CZ), Heidelberg University (DE), Singapore General Hospital (SG), University Hospital Heidelberg (DE), Centre Hospitalier Universitaire de Nice (FR), FIT Consulting (Italy) (IT), The Catholic University of Korea Yeouido St. Mary's Hospital (KR), Chia-Yi Christian Hospital (TW), German Center for Lung Research (DE), Instituto de Biomedicina de Sevilla (ES), University Hospital Hradec Králové (CZ), Amgen (Switzerland) (CH), Bases, Corpus, Langage (FR), Hospital Universitario Virgen del Rocío (ES), National Cheng Kung University Hospital (TW), University of Naples Federico II (IT), Universidad de Sevilla (ES), Catholic University of Korea (KR)
Amgen
Openalex Percentile: Top 11%
Cancer Genomics and Diagnostics
2.81
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