Supporting Biomarker-Driven Therapies in Oncology - A Genomic Testing Cost Calculator

Sep 24, 2026

Uploaded by Asher

Background: Adoption of high-throughput, gene panel-based next-generation sequencing (NGS) into routine cancer care is widely supported, yet constrained by cost concerns. To guide genomic testing policies, the study introduces a metric, cost per correctly identified patient (CCIP), comparing sequential single-gene testing (SGT) with multiplex NGS across tumor types. Materials and Methods: A genomic testing cost calculator estimates CCIP using clinically actionable alterations and diagnostic sensitivity/specificity and prevalence inputs.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Background

Materials and Methods

Results

Conclusions

Implications for Practice

Introduction

Supporting Biomarker-Driven Therapies in Oncology: A Genomic Testing Cost Calculator Albrecht Stenzinger*, 1, Brian Cuffel2, Noman Paracha2, Eric Vail3, Jesus Garcia-Foncillas4, Clifford Goodman5, Ulrik Lassen6, Gilles Vassal7, Sean D. Sullivan8 1 Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany 2 Bayer Pharmaceuticals, Basel, Switzerland 3Department of Pathology and Laboratory Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA 4University Cancer Institute and the Department of Oncology, University Hospital Fundacion Jimenez Diaz, Madrid, Spain 5The Lewin Group, Inc., Falls Church, VA, USA 6Department of Oncology, Copenhagen University Hospital, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark 7Gustave Roussy Comprehensive Cancer Center, Villejuif, France 8CHOICE Institute, Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA, USA * Corresponding author: Albrecht Stenzinger, MD, Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, 69120 Heidelberg, Germany. Tel: +49(0)62215634380; Fax: +49(0)6221565251; Email: Albrecht.Stenzinger@med.uni-heidelberg.de Abstract Background: Adoption of high-throughput, gene panel-based, next-generation sequencing (NGS) into routine cancer care is widely supported, but hampered by concerns about cost. To inform policies regarding genomic testing strategies, we propose a simple metric, cost per correctly identified patient (CCIP), that compares sequential single-gene testing (SGT) vs. multiplex NGS in different tumor types. Materials and Methods: A genomic testing cost calculator was developed based on clinically actionable genomic alterations identified in the European Society for Medical Oncology Scale for Clinical Actionability of molecular Targets. Using sensitivity/specificity data for SGTs (immunohistochemistry, polymerase chain reaction, and fluorescence in situ hybridization) and NGS and marker prevalence, the number needed to predict metric was monetarized to estimate CCIP. Results: At base case, CCIP was lower with NGS than sequential SGT for advanced/metastatic non-squamous non-small cell lung cancer (NSCLC), breast, colorectal, gastric cancers, and cholangiocarcinoma. CCIP with NGS was also favorable for squamous NSCLC, pancreatic, and hepatic cancers, but with overlapping confidence intervals. CCIP favored SGT for prostate cancer. Alternate scenarios using different price estimates for each test showed similar trends, but with incremental changes in the magnitude of difference between NGS and SGT, depending on price estimates for each test. Conclusions: The cost to correctly identify clinically actionable genomic alterations was lower for NGS than sequential SGT in most cancer types evaluated. Decreasing price estimates for NGS and the rapid expansion of targeted therapies and accompanying biomarkers are anticipated to further support NGS as a preferred diagnostic standard for precision oncology. Key words: precision oncology; next-generation sequencing; calculator; biomarker. Implications for Practice With the rapid development and approval of targeted therapies and accompanying clinically actionable genomic alterations, the genomic testing cost calculator described herein demonstrates the case for using next-generation sequencing (NGS) and other multiplex diagnostic advances over that of sequential single-gene testing (SGT) . By providing an analytical framework that informs local and national policymakers on the value of investing in a transition from sequential SGT to diagnostic, multiplex NGS, patients will benefit from early identification of matched therapies that have proven clinical benefit, leading to improved clinical outcomes and quality of life, while offsetting the incremental costs of sequential SGTs. Introduction Rapid progress in identifying oncogenic driver mutations, along with advances in molecular diagnostics, has paved the wa

FAQs

What problem does the genomic testing cost calculator address?

It addresses cost concerns limiting routine adoption of high-throughput NGS in cancer care by quantifying testing economics across tumor types.

How does the calculator compare NGS with sequential single-gene testing?

It uses the CCIP metric to compare sequential SGT versus multiplex NGS, incorporating diagnostic sensitivity/specificity data and the prevalence of clinically actionable biomarkers.

What are the main findings across cancer types?

NGS yields lower CCIP than sequential SGT in most evaluated cancer types, with CCIP favoring SGT in prostate cancer; alternative pricing scenarios preserve similar overall trends.

Sep 24, 2026

Uploaded by Asher