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Incorporating diagnostic testing into economic evaluations of tumour-agnostic therapies
Tamás Zelei1, Gábor Kovács1, Shirin Ashrafganjouei2
1Syreon Research Institute, Budapest, Hungary.
Introduction:
Tumor-agnostic treatments represent paradigm shift in oncology, targeting specific genetic mutations irrespective of the tumor's anatomical origin. This personalized approach relies on companion diagnostic testing to identify patients likely to respond to treatment. However, incorporating molecular diagnostics poses challenges to healthcare systems, particularly regarding costs and accessibility. This must be addressed in economic evaluations to guide health technology assessment and reimbursement decisions.
Areas Covered:
This study reviewed economic evaluations of tumor-agnostic therapies, focusing on the role of diagnostic testing. A literature search identified 13 compounds targeting nine molecular alterations, with eight relevant publications analyzed. The review revealed heterogeneity in how diagnostic testing is incorporated into cost-effectiveness models. While some studies excluded the costs and consequences of diagnostic tests entirely, others included them partially or fully. Key findings underscore the substantial impact of testing, particularly for low-prevalence biomarkers.
Expert Opinion:
Integrating diagnostic testing into economic evaluations is essential for accurately assessing the health economic value of tumor-agnostic therapies. Economic models must account for test-treatment combinations and consider shifts in treatment pathways compared to routine practice. As the field evolves, the development of robust frameworks and clear guidance on the requirements are crucial to support sustainable and equitable healthcare decision-making.
Insights
Tumor-agnostic therapies require companion diagnostic testing, but economic evaluations often omit these costs. Accurately assessing value necessitates including diagnostic test costs and consequences, especially for rare biomarkers.
Area of Science:
- Oncology
- Health Economics
- Molecular Diagnostics
Background:
- Tumor-agnostic therapies target specific genetic mutations, regardless of tumor origin, representing a personalized oncology approach.
- Companion diagnostic testing is crucial for identifying eligible patients but presents healthcare system challenges regarding cost and accessibility.
- Economic evaluations are vital for health technology assessment and reimbursement decisions for these novel therapies.
Purpose of the Study:
- To review economic evaluations of tumor-agnostic therapies, with a specific focus on the integration and impact of diagnostic testing.
- To identify heterogeneity in cost-effectiveness models concerning the inclusion of diagnostic testing costs and outcomes.
Main Methods:
- A literature search identified compounds targeting molecular alterations and relevant economic evaluation publications.
- Analysis focused on eight publications that incorporated diagnostic testing into cost-effectiveness models for tumor-agnostic treatments.
- Key findings were synthesized regarding the methods of incorporating diagnostic testing and its impact on economic value.
Main Results:
- Eight publications were analyzed, revealing varied approaches to incorporating diagnostic testing in economic models.
- Some studies excluded diagnostic test costs and consequences, while others included them partially or fully.
- The impact of diagnostic testing, particularly for low-prevalence biomarkers, was found to be substantial.
Conclusions:
- Integrating diagnostic testing into economic evaluations is essential for accurately assessing the health economic value of tumor-agnostic therapies.
- Economic models must account for test-treatment combinations and shifts in treatment pathways.
- Developing robust frameworks and guidance is crucial for sustainable and equitable healthcare decision-making in this evolving field.
