Targeted High-throughput Sequencing for Hematological Malignancies: A GBMHM Survey of Practice and Cost Evaluation in France.
Hemasphere
; 7(9): e943, 2023 Sep.
Article
em En
| MEDLINE
| ID: mdl-37637995
ABSTRACT
The objective of this study was to assess the clinical impact and financial costs of next-generation sequencing (NGS) in 5 categories of pediatric and adult hematological cancers. NGS prescriptions were prospectively collected from 26 laboratories, with varied technical and reporting practice (all or only significant targets). Impact was defined by the identification of (1) an actionable mutation, (2) a mutation with prognostic and/or theranostic value, and/or (3) a mutation allowing nosological refinement, reported by local investigators. A microcosting study was undertaken in 4 laboratories, identifying the types and volumes of resources required for each procedural step. Individual index prescriptions for 3961 patients were available for impact analysis on the management of myeloid disorders (two thirds) and, mainly mature B, lymphoid disorders (one third). NGS results were considered to impact the management for 73.4% of prescriptions useful for evaluation of prognostic risk in 34.9% and necessary for treatment adaptation (actionable) in 19.6%, but having no immediate individual therapeutic impact in 18.9%. The average overall cost per sample was 191 for the restricted mature lymphoid amplicon panel. Capture panel costs varied from 369 to 513 . Unit costs varied from 0.5 to 5.7 per kb sequenced, from 3.6 to 11.3 per target gene/hot-spot sequenced and from 4.3 to 73.8 per target gene/hot-spot reported. Comparable costs for the Amplicon panels were 5-8 per kb and 10.5-14.7 per target gene/hot-spot sequenced and reported, demonstrating comparable costs with greater informativity/flexibility for capture strategies. Sustainable funding of precision medicine requires a transparent discussion of its impact on care pathways and its financial aspects.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Evaluation_studies
/
Guideline
/
Health_economic_evaluation
Idioma:
En
Revista:
Hemasphere
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
França