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全外显子组测序在癌症分子诊断中的应用随时间减少:来自法国成本分析的证据。

Whole exome sequencing in molecular diagnostics of cancer decreases over time: evidence from a cost analysis in the French setting.

机构信息

Biostatistics and Epidemiology Unit, Gustave Roussy Cancer Centre, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.

Centre for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.

出版信息

Eur J Health Econ. 2021 Aug;22(6):855-864. doi: 10.1007/s10198-021-01293-1. Epub 2021 Mar 25.

Abstract

OBJECTIVES

Although high-throughput sequencing is revolutionising medicine, data on the actual cost of whole exome sequencing (WES) applications are needed. We aimed at assessing the cost of WES at a French cancer institute in 2015 and 2018.

METHODS

Actual costs of WES application in oncology research were determined using both micro-costing and gross-costing for the years 2015 and 2018, before and after the acquisition of a new sequencer. The entire workflow process of a WES test was tracked, and the number and unit price of each resource were identified at the most detailed level, from library preparation to bioinformatics analyses. In addition, we conducted an ad hoc analysis of the bioinformatics storage costs of data issued from WES analyses.

RESULTS

The cost of WES has decreased substantially, from €1921 per sample (i.e. cost of €3842 per patient) in 2015 to €804 per sample (i.e. cost of €1,608 per patient) in 2018, representing a decrease of 58%. In the meantime, the cost of bioinformatics storage has increased from €19,836 to €200,711.

CONCLUSION

This study suggests that WES cost has decreased significantly in recent years. WES has become affordable, even though clinical utility and efficiency still need to be confirmed.

摘要

目的

虽然高通量测序正在彻底改变医学,但仍需要了解全外显子组测序(WES)应用的实际成本数据。我们旨在评估 2015 年和 2018 年法国一家癌症研究所 WES 应用的成本。

方法

使用微观成本和总成本法,分别确定了 2015 年和 2018 年(在购买新测序仪之前和之后)WES 应用在肿瘤研究中的实际成本。对 WES 测试的整个工作流程进行了跟踪,并在最详细的层面上确定了每个资源的数量和单价,从文库制备到生物信息学分析。此外,我们还对 WES 分析产生的数据的生物信息学存储成本进行了专门分析。

结果

WES 的成本大幅下降,从 2015 年的每个样本 1921 欧元(即每个患者 3842 欧元)降至 2018 年的每个样本 804 欧元(即每个患者 1608 欧元),降幅为 58%。与此同时,生物信息学存储成本从 19836 欧元增加到 200711 欧元。

结论

本研究表明,近年来 WES 的成本显著降低。尽管临床实用性和效率仍有待证实,但 WES 已变得负担得起。

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