The Cost and Cost Trajectory of Whole-genome Analysis Guiding Treatment of Patients with Advanced Cancers

Overview

Journal Mol Genet Genomic Med

Specialty Genetics

Date 2017 May 27

PMID 28546995

Citations 22

Authors

Deirdre Weymann

Janessa Laskin

Robyn Roscoe

Kasmintan A Schrader

Stephen Chia

Stephen Yip

Winson Y Cheung

Karen A Gelmon

Aly Karsan

Daniel J Renouf

Marco Marra

Dean A Regier

Affiliations

Soon will be listed here.

Abstract

Background: Limited data exist on the real-world costs of applying whole-genome analysis (WGA) in a clinical setting. We estimated the costs of applying WGA to guide treatments for patients with advanced cancers and characterized how costs evolve over time.

Methods: The setting is the British Columbia Cancer Agency Personalized OncoGenomics (POG) program in British Columbia, Canada. Cost data were obtained for patients who enrolled in the program from 2012 to 2015. We estimated mean WGA costs using bootstrapping. We applied time series analysis and produced 10-year forecasts to determine when costs are expected to reach critical thresholds.

Results: The mean cost of WGA over the study period was CDN$34,886 per patient (95% CI: $34,051, $35,721). Over time, WGA costs decreased, driven by a reduction in costs of sequencing. Yet, costs of other components of WGA increased. Forecasting showed WGA costs may not reach critical thresholds within the next 10 years.

Conclusion: WGA costs decreased over the studied time horizon, but expenditures needed to realize WGA remain significant. Future research exploring costs and benefits of WGA-guided cancer care are crucial to guide health policy.

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References

Gallego C, Shirts B, Bennette C, Guzauskas G, Amendola L, Horike-Pyne M . Next-Generation Sequencing Panels for the Diagnosis of Colorectal Cancer and Polyposis Syndromes: A Cost-Effectiveness Analysis. J Clin Oncol. 2015; 33(18):2084-91. PMC: 4461806. DOI: 10.1200/JCO.2014.59.3665. View

van Amerongen R, Retel V, Coupe V, Nederlof P, Vogel M, van Harten W . Next-generation sequencing in NSCLC and melanoma patients: a cost and budget impact analysis. Ecancermedicalscience. 2016; 10:684. PMC: 5102690. DOI: 10.3332/ecancer.2016.684. View

Laskin J, Jones S, Aparicio S, Chia S, Chng C, Deyell R . Lessons learned from the application of whole-genome analysis to the treatment of patients with advanced cancers. Cold Spring Harb Mol Case Stud. 2016; 1(1):a000570. PMC: 4850882. DOI: 10.1101/mcs.a000570. View

Kilpivaara O, Aaltonen L . Diagnostic cancer genome sequencing and the contribution of germline variants. Science. 2013; 339(6127):1559-62. DOI: 10.1126/science.1233899. View

Monroe G, Frederix G, Savelberg S, de Vries T, Duran K, van der Smagt J . Effectiveness of whole-exome sequencing and costs of the traditional diagnostic trajectory in children with intellectual disability. Genet Med. 2016; 18(9):949-56. DOI: 10.1038/gim.2015.200. View

Xue Y, Ankala A, Wilcox W, Hegde M . Solving the molecular diagnostic testing conundrum for Mendelian disorders in the era of next-generation sequencing: single-gene, gene panel, or exome/genome sequencing. Genet Med. 2014; 17(6):444-51. DOI: 10.1038/gim.2014.122. View

Metzker M . Sequencing technologies - the next generation. Nat Rev Genet. 2009; 11(1):31-46. DOI: 10.1038/nrg2626. View

Barber J, Thompson S . Analysis of cost data in randomized trials: an application of the non-parametric bootstrap. Stat Med. 2000; 19(23):3219-36. DOI: 10.1002/1097-0258(20001215)19:23<3219::aid-sim623>3.0.co;2-p. View

Caulfield T, Evans J, McGuire A, McCabe C, Bubela T, Cook-Deegan R . Reflections on the cost of "low-cost" whole genome sequencing: framing the health policy debate. PLoS Biol. 2013; 11(11):e1001699. PMC: 3818164. DOI: 10.1371/journal.pbio.1001699. View

10.

Plothner M, Frank M, von der Schulenburg J . Cost analysis of whole genome sequencing in German clinical practice. Eur J Health Econ. 2016; 18(5):623-633. DOI: 10.1007/s10198-016-0815-0. View

11.

Ellis M, Ding L, Shen D, Luo J, Suman V, Wallis J . Whole-genome analysis informs breast cancer response to aromatase inhibition. Nature. 2012; 486(7403):353-60. PMC: 3383766. DOI: 10.1038/nature11143. View

12.

Shekhar Pareek C, Smoczynski R, Tretyn A . Sequencing technologies and genome sequencing. J Appl Genet. 2011; 52(4):413-35. PMC: 3189340. DOI: 10.1007/s13353-011-0057-x. View

13.

Stephens Z, Lee S, Faghri F, Campbell R, Zhai C, Efron M . Big Data: Astronomical or Genomical?. PLoS Biol. 2015; 13(7):e1002195. PMC: 4494865. DOI: 10.1371/journal.pbio.1002195. View

14.

Sabatini L, Mathews C, Ptak D, Doshi S, Tynan K, Hegde M . Genomic Sequencing Procedure Microcosting Analysis and Health Economic Cost-Impact Analysis: A Report of the Association for Molecular Pathology. J Mol Diagn. 2016; 18(3):319-328. PMC: 7212689. DOI: 10.1016/j.jmoldx.2015.11.010. View

15.

Manolio T, Chisholm R, Ozenberger B, Roden D, Williams M, Wilson R . Implementing genomic medicine in the clinic: the future is here. Genet Med. 2013; 15(4):258-67. PMC: 3835144. DOI: 10.1038/gim.2012.157. View

16.

Service R . Gene sequencing. The race for the $1000 genome. Science. 2006; 311(5767):1544-6. DOI: 10.1126/science.311.5767.1544. View

17.

Sboner A, Mu X, Greenbaum D, Auerbach R, Gerstein M . The real cost of sequencing: higher than you think!. Genome Biol. 2011; 12(8):125. PMC: 3245608. DOI: 10.1186/gb-2011-12-8-125. View

18.

Wangaryattawanich P, Hatami M, Wang J, Thomas G, Flanders A, Kirby J . Multicenter imaging outcomes study of The Cancer Genome Atlas glioblastoma patient cohort: imaging predictors of overall and progression-free survival. Neuro Oncol. 2015; 17(11):1525-37. PMC: 4648306. DOI: 10.1093/neuonc/nov117. View

19.

Costa S, Regier D, Meissner B, Cromwell I, Ben-Neriah S, Chavez E . A time-and-motion approach to micro-costing of high-throughput genomic assays. Curr Oncol. 2016; 23(5):304-313. PMC: 5081006. DOI: 10.3747/co.23.2987. View

20.

Roychowdhury S, Iyer M, Robinson D, Lonigro R, Wu Y, Cao X . Personalized oncology through integrative high-throughput sequencing: a pilot study. Sci Transl Med. 2011; 3(111):111ra121. PMC: 3476478. DOI: 10.1126/scitranslmed.3003161. View