Research presented at AMCP Nexus 2024 explores the costs of upfront biomarker testing in advanced non–small cell lung cancer (aNSCLC) and metastatic colorectal cancer (mCRC), showing that multigene panel testing (MGPT) can increase eligibility for targeted therapy while representing a small portion of the total cost of care.

State policymakers are concerned about the cost of biomarker testing for patients with aNSCLC and mCRC, despite guidelines recommending testing for targeted therapy. This study aimed to analyze the costs of biomarker testing in relation to the total cost of care for these patients. A retrospective analysis of medical and pharmacy claims from 2018 to 2022 was conducted to assess biomarker test costs, receipt of targeted therapy, and total costs for patients with aNSCLC or mCRC.

A total of 24 828 patients were included in the study, with 11% receiving upfront MGPT, 67% receiving upfront SGT only, and 22% having no evidence of upfront testing. Among those who underwent upfront testing, a higher percentage of patients who received upfront MGPT received targeted therapy compared to those who received upfront SGT only. 

The average cost of all upfront biomarker tests for patients who received upfront MGPT was $4400, while those who received SGT only had an average cost of $1318. The total cost of care per patient across both groups varied depending on follow-up time, with costs being $248 561 for those with less than one year of follow-up and $323 953 for those with more than one year of follow-up. The cost of upfront biomarker testing as a portion of the total cost of care was 2.8% for those who received upfront MGPT and 0.9% for those who received upfront SGT only.

“Upfront MGPT increased identification of patients who are eligible for targeted therapy while representing a small portion of the TCOC. Further efforts are needed to facilitate access to comprehensive testing, such as state laws requiring coverage consistent with guidelines,” said researchers. 

Reference
Wong W and To T. Real-world costs associated with upfront biomarker testing in advanced non–small cell lung cancer and metastatic colorectal cancer. Presented at: AMCP Nexus 2024; October 14-17; Las Vegas, NV.