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Budget impact analysis of comprehensive genomic profiling for untreated advanced or recurrent solid cancers in Japan
Wentao Tang1, Keigo Hanada2, Yoshiharu Motoo3
1Chugai Pharmaceutical Co., Ltd, Tokyo, Japan.
Aims:
In Japan, the use of comprehensive genomic profiling (CGP) is only available for cancer patients who have no standard of care (SoC), or those who have completed SoC. This may lead to missed treatment opportunities for patients with druggable alterations. In this study, we evaluated the potential impact of CGP testing before SoC on medical costs and clinical outcome in untreated patients with advanced or recurrent biliary tract cancer (BTC), non-squamous non-small cell lung cancer (NSQ-NSCLC), or colorectal cancer (CRC) in Japan between 2022 and 2026.
Materials And Methods:
We constructed a decision-tree model reflecting the healthcare environment of Japan, to estimate the clinical outcome and medical costs impact of CGP testing by comparing two groups (with vs without CGP testing before SoC). The epidemiological parameters, detection rates of druggable alterations, and overall survival were collected from literature and claims databases in Japan. Treatment options selected based on druggable alterations were set in the model based on clinical experts' opinions.
Results:
In 2026, the number of untreated patients with advanced or recurrent BTC, NSQ-NSCLC, and CRC was estimated to be 8600, 32,103, and 24,896, respectively. Compared with the group without CGP testing before SoC, CGP testing before SoC increased druggable alteration detection and treatment rate with matched therapies in all three cancer types. The medical costs per patient per month were estimated to increase with CGP testing before SoC in the three cancer types by 19,600, 2900, and 2200 JPY (145, 21, and 16 USD), respectively.
Limitations:
Only those druggable alterations with matched therapies were considered in the analysis model, while the potential impact of other genomic alterations provided by CGP testing was not considered.
Conclusions:
The present study suggested that CGP testing before SoC may improve patient outcomes in various cancer types with a limited and controllable increase in medical costs.
Insights
Comprehensive genomic profiling (CGP) before standard of care (SoC) in Japan may improve cancer treatment outcomes for biliary tract cancer, lung cancer, and colorectal cancer patients. This approach shows potential for better patient results with manageable cost increases.
Area of Science:
- Oncology
- Genomics
- Health Economics
Background:
- Current Japanese guidelines restrict comprehensive genomic profiling (CGP) to patients without standard of care (SoC) or after SoC completion.
- This restriction may cause patients with actionable genomic alterations to miss timely treatment opportunities.
- Advanced or recurrent biliary tract cancer (BTC), non-squamous non-small cell lung cancer (NSQ-NSCLC), and colorectal cancer (CRC) are key areas of concern.
Purpose of the Study:
- To evaluate the impact of CGP testing *before* SoC on medical costs and clinical outcomes.
- To analyze this impact in untreated patients with advanced or recurrent BTC, NSQ-NSCLC, and CRC in Japan.
- To model the healthcare landscape between 2022 and 2026.
Main Methods:
- A decision-tree model was developed, simulating the Japanese healthcare system.
- The model compared outcomes and costs for patients who received CGP before SoC versus those who did not.
- Epidemiological data, druggable alteration detection rates, and overall survival were sourced from literature and Japanese claims databases.
Main Results:
- CGP testing before SoC was estimated to increase the detection of actionable mutations and subsequent targeted therapy rates across all three cancer types.
- In 2026, the estimated patient populations were 8600 (BTC), 32,103 (NSQ-NSCLC), and 24,896 (CRC).
- Per-patient monthly medical costs were projected to increase by JPY 19,600 (USD 145) for BTC, JPY 2900 (USD 21) for NSQ-NSCLC, and JPY 2200 (USD 16) for CRC.
Conclusions:
- CGP testing prior to SoC demonstrates potential to enhance patient outcomes in various cancers.
- The associated increase in medical costs is considered limited and controllable.
- This strategy may represent a valuable approach for optimizing cancer care in Japan.
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