Estimating the costs of genomic sequencing in cancer control

BMC Health Services Research

Anthony G. Beckhouse¹  Deborah J. Schofield²  Katia Nones²  Penelope M. Webb³  Louisa G. Gordon³  Thomas M. Elliott³  Astrid J. Rodriguez-Acevedo³  Xing J. Lee⁴  Nicholas Graves⁴  Nicole M. White⁴ 

[1] BGI Australia;QIMR Berghofer Medical Research Institute, Medical Genomics Laboratory;QIMR Berghofer Medical Research Institute, Population Health Department;Queensland University of Technology (QUT), Australian Centre for Health Services Innovation, Institute of Health and Biomedical Innovation;

关键词: Genomic sequencing;    Cancer;    Cost-analysis;    Micro-costing;   

DOI  :  10.1186/s12913-020-05318-y

来源: DOAJ

【 摘 要 】

Abstract Background Despite the rapid uptake of genomic technologies within cancer care, few studies provide detailed information on the costs of sequencing across different applications. The objective of the study was to examine and categorise the complete costs involved in genomic sequencing for a range of applications within cancer settings. Methods We performed a cost-analysis using gross and micro-costing approaches for genomic sequencing performed during 2017/2018 across different settings in Brisbane, Australia. Sequencing was undertaken for patients with lung, breast, oesophageal cancers, melanoma or mesothelioma. Aggregated resource data were captured for a total of 1433 patients and point estimates of per patient costs were generated. Deterministic sensitivity analyses addressed the uncertainty in the estimates. Estimated costs to the public health system for resources were categorised into seven distinct activities in the sequencing process: sampling, extraction, library preparation, sequencing, analysis, data storage and clinical reporting. Costs were also aggregated according to labour, consumables, testing, equipment and ‘other’ categories. Results The per person costs were AU$347–429 (2018 US$240–297) for targeted panels, AU$871–$2788 (2018 US$604–1932) for exome sequencing, and AU$2895–4830 (2018 US$2006-3347) for whole genome sequencing. Cost proportions were highest for library preparation/sequencing materials (average 76.8% of total costs), sample extraction (8.1%), data analysis (9.2%) and data storage (2.6%). Capital costs for the sequencers were an additional AU$34–197 (2018 US$24–67) per person. Conclusions Total costs were most sensitive to consumables and sequencing activities driven by commercial prices. Per person sequencing costs for cancer are high when tumour/blood pairs require testing. Using the natural steps involved in sequencing and categorising resources accordingly, future evaluations of costs or cost-effectiveness of clinical genomics across cancer projects could be more standardised and facilitate easier comparison of cost drivers.

【 授权许可】

Unknown