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Cost-Effectiveness of Comprehensive Genomic Profiling in Patients With Non-Small Cell Lung Cancer for the Colombian Health System.
Gamboa, Oscar; Bonilla, Carlos Eduardo; Quitian, David; Torres, Gabriel Fernando; Buitrago, Giancarlo; Cardona, Andrés F.
Afiliação
  • Gamboa O; Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Colombia, Bogotá DC, Bogotá. Electronic address: oagamboag@gmail.com.
  • Bonilla CE; Fundación Colombiana de Cancerología Clínica Vida, Colombia, Antioquia, Medellín.
  • Quitian D; Productos Roche S.A., Colombia, Bogotá DC, Bogotá.
  • Torres GF; Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Colombia, Bogotá DC, Bogotá.
  • Buitrago G; Faculty of Medicine, Universidad Nacional de Colombia, Colombia, Bogotá DC, Bogotá.
  • Cardona AF; Foundation for Clinical and Applied Cancer Research (FICMAC), Colombia, Bogotá DC, Bogotá.
Value Health Reg Issues ; 39: 115-125, 2024 Jan.
Article em En | MEDLINE | ID: mdl-38101152
ABSTRACT

INTRODUCTION:

The use of comprehensive genomic profiling (CGP) and target therapies is associated with substantial improvements in clinical outcomes among patients with non-small cell lung cancer (NSCLC). However, the costs of CGP may increase the financial pressures of NSCLC on health systems worldwide, especially in low- and middle-income countries. This study aimed to estimate the cost-effectiveness of CGP compared with current genomic tests in patients with NSCLC from the perspective of the Colombian Health System.

METHODS:

To estimate the costs and benefits of CGP and its comparators, we developed a 2-stage cohort model with a lifetime horizon. In the first stage, we made up a decision tree that calculated the probability of receiving each therapy as result of identifying a specific, actionable target. In the second stage, we developed a partitioned survival model that estimated the time spent at each health state. Incremental cost-effectiveness ratios were calculated for life-years (LYs) and quality-adjusted LYs gained. All costs were expressed in 2019 international dollars (INT$).

RESULTS:

CGP is associated with gains of 0.06 LYs and 0.04 quality-adjusted LYs compared with current genomic tests. Incremental cost-effectiveness ratios for CGP ranged from INT$861 to INT$7848, depending on the outcome and the comparator. Sensitivity analyses show that the cost-effectiveness decision was sensitive to prices of CGP above INT$7170 per test. These results are robust to most deterministic and probabilistic sensitivity analyses.

CONCLUSIONS:

CGP may be cost-effective in patients with NSCLC from the perspective of the Colombian Health System (societal willingness-to-pay threshold of INT$15 630 to INT$46 890).
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Neoplasias Pulmonares Limite: Humans País/Região como assunto: America do sul / Colombia Idioma: En Revista: Value Health Reg Issues Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Neoplasias Pulmonares Limite: Humans País/Região como assunto: America do sul / Colombia Idioma: En Revista: Value Health Reg Issues Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos