The Potential Value-Based Price of a Multi-Cancer Early Detection Genomic Blood Test to Complement Current Single Cancer Screening in the USA

Abstract

Background Multi-cancer early detection (MCED) testing could increase detection of cancer at early stages, when survival outcomes are better and treatment costs are lower, but is expected to increase screening costs. This study modeled an MCED test for 19 solid cancers in a US population and estimated the potential value-based price (the maximum price to meet a given willingness to pay) of the MCED test plus current single cancer screening (usual care) compared to usual care alone from a third-party payer perspective over a lifetime horizon. Methods A hybrid cohort-level state-transition and decision-tree model was developed to estimate the clinical and economic outcomes of annual MCED testing between age 50 and 79 years. The impact on time and stage of diagnosis was computed using an interception modeling approach, with the consequences of cancer modeled based on stage at diagnosis. The model parameters were mainly sourced from the literature, including a published case-control study to inform MCED test performance. All costs were inflated to 2021 US dollars. Results Multi-cancer early detection testing shifted cancer diagnoses to earlier stages, with a 53% reduction in stage IV cancer diagnoses, resulting in longer overall survival compared with usual care. Addition of MCED decreased per cancer treatment costs by $5421 and resulted in a gain of 0.13 and 0.38 quality-adjusted life-years across all individuals in the screening program and those diagnosed with cancer, respectively. At a willingness-to-pay threshold of $100,000 per quality-adjusted lifeyear gained, the potential value-based price of an MCED test was estimated at $1196. The projected survival of individuals diagnosed with cancer and the number of cancers detected at an earlier stage by MCED had the greatest impact on outcomes. Conclusions An MCED test with high specificity would potentially improve long-term health outcomes and reduce cancer treatment costs, resulting

The association of race/ethnicity in male breast cancer survival within similar comorbidity cohorts

“…In addition, the advent of liquid biopsies may eventually provide a mechanism for annual screening for all cancers. Although these tests are in their infancy, not widely available, and it is uncertain whether they will become cost efficient for standard testing, they have the potential increase early detection of breast cancer in men 52–54 …”

“…Although these tests are in their infancy, not widely available, and it is uncertain whether they will become cost efficient for standard testing, they have the potential increase early detection of breast cancer in men. [52][53][54] Retrospective, population-based studies using cancer registry data have limitations.…”

Noninvasive detection of any-stage cancer using free glycosaminoglycans

“…From a technical standpoint, based on the experience from this study and foreseeable optimizations, we expect a throughput of 100 patient samples per day per UHPLC-MS/MS instrument at a cost per sample <$50. This cost is 5-10 times lower than a previous estimate for a cfDNA/ protein-based MCED test (8) and well below its presumed health economics value of ~$1200 (31). The final cost depends on whether the free GAGome MCED test requires one (urine or plasma) or two samples (both urine and plasma) per patient.…”

Early Detection of Cancers in the Era of Precision Oncology

“…Of these, 26 were initially detected by blood testing. Although this study found the MCED test to be far from ideal on its own, in combination with diagnostic imaging, it could improve early cancer detection [58 ▪▪ ]. The addition of an annual MCED test would cost $5421 for patients and is predicted to provide 0.34 years of quality-adjusted life for a single person.…”