On 3 April 2020, MPCCC hosted its first online Precision Oncology Seminar, presented by health economics expert Professor Maarten IJzerman during which he presented his work on the health economic analysis of implementing comprehensive vs standard of care tumour molecular profiling.

Professor IJzerman is a VCCC Professor and Head of Cancer Health Services Research at the University of Melbourne’s Centre for Cancer Research and Health Policy. He advocated for reframing the economic models used to evaluate molecular tumour profiling.

In his talk, he investigated one key question:

Can we use data modelling to show that the extra cost of Comprehensive Genome Profiling (CGP) is worth it in the long run to the health economy?

Comprehensive genome profiling (CGP) uses next-generation sequencing (NGS) technology on either a large panel of genes (roughly 500 genes), or on whole exomes, compared to current standard of care (SoC) molecular tumour tests, which might test only 5-6 genes with a less sensitive method.

NGS-based CGP of tumours can be the difference between discovering an actionable mutation and missing it, since it profiles a much larger number of genes using a more sensitive technology than SoC tests, and thereby are capable of identifying a broader range of mutations in cancer-related genes. This information can influence a patient’s treatment, for example directing them to a targeted drug therapy that ‘matches’ their mutation. CGP can also provide prognostic or predictive information about how a patient will respond to particular therapies. This more comprehensive molecular profiling technology of a cancer patients’ tumour can therefore alter the course of their treatment, and have a marked impact on their disease outcome.

Comprehensive tumour profiling by NGS is considerably more expensive and is not subsidised in Victoria, meaning that access to its benefits are out of reach of many patients. Whilst panel-based CGP can be accessed privately, such as via the FDA-approved Foundation CDx panel, patients may be $5,000 out of pocket.

Parameters such as the cost of in-hospital bed days and outpatient visits, or the cost of ineffective therapies need to be incorporated into economic modelling and analyses. This can inform health policy by providing an evidence-based argument for the economic value of implementing a subsidised CGP test in  the Victorian healthcare system.

“Health economics should not be about reducing costs, but about preventing tests from presenting a false negative,” Professor IJzerman argued, and continued to explain the ways in which comprehensive tumour profiling makes more economic sense than the upfront costs have led health policy experts to believe.

Watch the full video recording of Professor IJzerman’s seminar to learn more about this perspective.

MPCCC Precision Oncology Seminars invite guest speakers to discuss the latest innovations and research in the field of precision oncology, and to provide a platform for education and discussion within the precision oncology workforce. To find out more about the seminar series, see here.