Weymann Deirdre, Laskin Janessa, Roscoe Robyn, Schrader Kasmintan A, Chia Stephen, Yip Stephen, Cheung Winson Y, Gelmon Karen A, Karsan Aly, Renouf Daniel J, Marra Marco, Regier Dean A
Canadian Centre for Applied Research in Cancer Control (ARCC)Cancer Control ResearchBC Cancer AgencyVancouverBritish ColumbiaCanada.
Division of Medical OncologyBC Cancer AgencyVancouverBritish ColumbiaCanada.
Mol Genet Genomic Med. 2017 Mar 12;5(3):251-260. doi: 10.1002/mgg3.281. eCollection 2017 May.
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.
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.
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.
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.
关于在临床环境中应用全基因组分析（WGA）的实际成本的数据有限。我们估计了应用WGA指导晚期癌症患者治疗的成本，并描述了成本随时间的变化情况。
研究背景为加拿大不列颠哥伦比亚省的不列颠哥伦比亚癌症机构个性化肿瘤基因组学（POG）项目。获取了2012年至2015年参与该项目患者的成本数据。我们使用自助法估计了WGA的平均成本。我们应用时间序列分析并进行了10年预测，以确定成本预计何时达到临界阈值。
研究期间WGA的平均成本为每位患者34,886加元（95%置信区间：34,051加元，35,721加元）。随着时间的推移，WGA成本下降，这是由测序成本的降低推动的。然而，WGA其他组成部分的成本有所增加。预测显示，WGA成本在未来10年内可能不会达到临界阈值。
在所研究的时间范围内，WGA成本有所下降，但实现WGA所需的支出仍然很高。未来探索WGA指导的癌症护理的成本和效益的研究对于指导卫生政策至关重要。
