Department of Biomedical Science, Chang Gung University, TaoYuan, Taiwan; Roche Product, Inc, Taipei, Taiwan.
Department of Biomedical Science, Chang Gung University, TaoYuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, TaoYuan, Taiwan; Research Services Center for Health Information, Chang Gung University, TaoYuan, Taiwan; Clinical Informatics and Medical Statistics Research Center, Chang Gung University, TaoYuan, Taiwan; Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital. TaoYuan, Taiwan.
Value Health Reg Issues. 2023 May;35:48-56. doi: 10.1016/j.vhri.2022.12.004. Epub 2023 Feb 28.
The concept of precision oncology using genetic testing has become popular for cancer treatment in recent years. This research aimed to evaluate the financial impact of comprehensive genomic profiling (CGP) in patients with advanced non-small cell lung cancer before receiving any systemic treatments, compared with current practice using single-gene testing, in the hope that the findings can inform the National Health Insurance Administration the decision regarding CGP reimbursement.
A budget impact analysis model was developed comparing the sum of gene testing costs, the first-line and subsequent systemic treatment costs, and other medical costs between the current practice of traditional molecular testing and the new test strategy of CGP. The evaluation time horizon is 5 years from the perspective of the National Health Insurance Administration. Outcome endpoints were incremental budget impact and life-year gained.
This research indicated CGP reimbursement would benefit 1072 to 1318 more patients receiving target therapies than the current practice and consequently had incremental 232 to 1844 life-years gained from 2022 to 2026. The new test strategy also led to higher gene testing cost and systemic treatment cost. Nevertheless, less medical resource utilization and better patient outcome were demonstrated. The incremental budget impact ranged from US dollar 19 to US dollar 27 million in the 5-year period.
This research shows that CGP could pave the way for personalized healthcare with moderate increase of National Health Insurance budget.
近年来，利用基因检测进行精准肿瘤学的概念在癌症治疗中变得流行。本研究旨在评估在接受任何系统治疗之前，对晚期非小细胞肺癌患者进行全面基因组分析（CGP）与当前使用单基因检测的临床实践相比的财务影响，希望研究结果能为国家健康保险管理局关于 CGP 报销的决策提供信息。
通过从国家健康保险管理局的角度来看，建立了一个预算影响分析模型，比较了传统分子检测的当前实践和 CGP 新测试策略之间的基因检测成本、一线和后续系统治疗成本以及其他医疗成本的总和。评估时间范围为 5 年。结果终点是增量预算影响和增加的生命年。
研究表明，与当前实践相比，CGP 报销将使接受靶向治疗的患者增加 1072 至 1318 人，从而在 2022 年至 2026 年期间增加 232 至 1844 个生命年。新的测试策略还导致基因检测成本和系统治疗成本增加。然而，也展示了更低的医疗资源利用和更好的患者结局。在 5 年内，增量预算影响范围从 1900 万美元到 2700 万美元。
本研究表明，CGP 可以为个性化医疗保健铺平道路，同时适度增加国家健康保险预算。
