Cost-Effectiveness of Comprehensive Genomic Profiling in Patients With Non-Small Cell Lung Cancer for the Colombian Health System.

Autor: Gamboa O; Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Colombia, Bogotá DC, Bogotá. Electronic address: oagamboag@gmail.com., Bonilla CE; Fundación Colombiana de Cancerología Clínica Vida, Colombia, Antioquia, Medellín., Quitian D; Productos Roche S.A., Colombia, Bogotá DC, Bogotá., Torres GF; Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Colombia, Bogotá DC, Bogotá., Buitrago G; Faculty of Medicine, Universidad Nacional de Colombia, Colombia, Bogotá DC, Bogotá., Cardona AF; Foundation for Clinical and Applied Cancer Research (FICMAC), Colombia, Bogotá DC, Bogotá.
Jazyk: angličtina
Zdroj: Value in health regional issues [Value Health Reg Issues] 2024 Jan; Vol. 39, pp. 115-125. Date of Electronic Publication: 2023 Dec 14.
DOI: 10.1016/j.vhri.2023.08.006
Abstrakt: Introduction: The use of comprehensive genomic profiling (CGP) and target therapies is associated with substantial improvements in clinical outcomes among patients with non-small cell lung cancer (NSCLC). However, the costs of CGP may increase the financial pressures of NSCLC on health systems worldwide, especially in low- and middle-income countries. This study aimed to estimate the cost-effectiveness of CGP compared with current genomic tests in patients with NSCLC from the perspective of the Colombian Health System.
Methods: To estimate the costs and benefits of CGP and its comparators, we developed a 2-stage cohort model with a lifetime horizon. In the first stage, we made up a decision tree that calculated the probability of receiving each therapy as result of identifying a specific, actionable target. In the second stage, we developed a partitioned survival model that estimated the time spent at each health state. Incremental cost-effectiveness ratios were calculated for life-years (LYs) and quality-adjusted LYs gained. All costs were expressed in 2019 international dollars (INT$).
Results: CGP is associated with gains of 0.06 LYs and 0.04 quality-adjusted LYs compared with current genomic tests. Incremental cost-effectiveness ratios for CGP ranged from INT$861 to INT$7848, depending on the outcome and the comparator. Sensitivity analyses show that the cost-effectiveness decision was sensitive to prices of CGP above INT$7170 per test. These results are robust to most deterministic and probabilistic sensitivity analyses.
Conclusions: CGP may be cost-effective in patients with NSCLC from the perspective of the Colombian Health System (societal willingness-to-pay threshold of INT$15 630 to INT$46 890).
Competing Interests: Author Disclosures Drs Gamboa, Buitrago, and Torres reported receiving grants from Productos Roche Colombia S.A. during the conduct of the study. Dr Bonilla reported receiving honoraria for participation in advisory boards for Amgen, Janssen, Bristol, Merck Serono, Merck Sharp & Dohme, Pfizer, Roche, Bayer, AstraZeneca, and Novartis. He has reported receiving honoraria for participation as an investigator in clinical trials from Bristol, Merck Sharp & Dohme, and Pfizer. He has received sponsorship to attend oncology meetings from Bristol, Amgen, Janssen, Merck Sharp & Dohme, Merck Serono, and Roche. Dr Quitian reported receiving that he is a Productos Roche S.A. employee as a health economics lead. Dr Cardona reported receiving grants from Merck Sharp & Dohme, Boehringer Ingelheim, Productos Roche, Bristol-Myers Squibb, Foundation Medicine, Termo Fisher, Broad Institute, Amgen, Flatiron Health, Teva Pharma, Rochem Biocare, Bayer, INQBox, and Foundation for Clinical and Applied Cancer Research (FICMAC) outside the submitted work. He also reported receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from EISAI, Merck Serono, Jannsen Pharmaceutical, Merck Sharp & Dohme, Boehringer Ingelheim, Roche, Bristol-Myers Squibb, Pfizer, Novartis, Celldex Therapeutics, Foundation Medicine, Eli Lilly, Guardant Health, Illumina, and Foundation for Clinical and Applied Cancer Research (FICMAC); payment for expert testimony from Merck Sharp & Dohme, Boehringer Ingelheim, Roche, Bristol-Myers Squibb, Pfizer, Novartis, Foundation Medicine, Guardant Health, Illumina, and Foundation for Clinical and Applied Cancer Research (FICMAC); and support for attending meetings and/or travel from Merck Serono, Merck Sharp & Dohme, Boehringer Ingelheim, Roche, Bristol-Myers Squibb, Pfizer, Novartis, Celldex Therapeutics, Foundation Medicine, Eli Lilly, and Foundation for Clinical and Applied Cancer Research (FICMAC). No other disclosures were reported.
(Copyright © 2023 International Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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