As breakthroughs in personalized cancer treatment continue, delivering the specialized therapies in the most cost-effective manner has grown increasingly important. In a paper published in the British Journal of Cancer, University of Colorado School of Medicine researchers have identified new ways for allowing more patients to benefit from this revolution in cancer care.
Already, many insurance companies consider the cost of a drug and the benefits of its use when determining coverage. However, molecular profiling is being used more often to establish which patients would benefit most from certain cancer therapies. In addition, many new drugs are now being restricted to cancer patients with specific molecular subtypes of the disease. Therefore, health economist Adam Atherly, PhD, of the Colorado School of Public Health (CSPH), and medical oncologist D. Ross Camidge, MD, PhD, of the University of Colorado Cancer Center, claim the cost of molecular profiling of patients’ tumors for specific abnormalities must be considered.
“If you screen every patient with a molecular test to detect something that only occurs in 1% of them – in reality, treating each positive patient should also include the upfront costs of screening the other 99 negative patients,” said Atherly, professor of health systems management and policy for the CSPH. “If a test costs $1000, this means from society’s perspective you have to add $100,000 to the costs of treating each of the 1 in 100 patients that are positive. And this is before you have even started to consider the cost of the drug itself. When you consider these factors, some organizations may not view a new drug as cost-effective even if it works amazingly well for the small percentage who are proven positive by the test.”
Atherly and Camidge used recent breakthroughs by the University of Colorado’s lung cancer program to model their data. “In recent years, we have championed the practice of performing very sophisticated molecular tests on the tumors of every lung cancer patient we see. We then use this information to direct patients to the most appropriate targeted therapy for their cancer,” said Camidge, CU Cancer Center investigator and director of the thoracic oncology clinical program at University of Colorado Hospital.
Camidge continues, “The testing has certainly led to major breakthroughs in the treatment of lung cancer. But if we are going to roll these developments out across the US and around the world, we have to understand what this progress costs and how to make it affordable.”
Atherly and Camidge suggest 2 key ways for making molecular profiling more cost effective: First, testing could be recommended only to particular patients based on the presence of certain clinical factors that increase the chances of a patient having a specific molecular abnormality in their tumor. However, if patients do not fit into a classic stereotype, some tumor abnormalities may be missed. Second, the cost of the profiling test for each individual molecular abnormality could be reduced for every patient screened. Or, tests could be merged at a lower combined price, and doctors could determine the presence of several different abnormalities at the same time.
“We believe the only way to beat cancer is moving away from the one-size-fits-all model,” said Camidge. “To do this we must treat every person as an individual. But if we don’t think now about the costs of this approach and how to address them, these breakthroughs will never achieve their true potential.”
Source: University of Colorado.