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Clin Genitourin Cancer. 2019 Mar 27. pii: S1558-7673(19)30107-7. doi: 10.1016/j.clgc.2019.03.015. [Epub ahead of print]

Cost Analysis of Noninvasive Blood-Based MicroRNA Testing Versus CT Scans for Follow-up in Patients With Testicular Germ-Cell Tumors.

Author information

1
Bioscience Enterprise, University of Cambridge, Cambridge, England, UK; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY.
2
Bioscience Enterprise, University of Cambridge, Cambridge, England, UK.
3
Cambridge Enterprise Ltd, University of Cambridge, The Hauser Forum, Cambridge, England, UK.
4
Department of Pathology, University of Cambridge, Cambridge, England, UK; Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England, UK. Electronic address: nc109@cam.ac.uk.
5
Department of Pathology, University of Cambridge, Cambridge, England, UK; Department of Paediatric Haematology and Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England, UK. Electronic address: mjm16@cam.ac.uk.
6
Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, England, UK. Electronic address: Ed.Wilson@uea.ac.uk.

Abstract

BACKGROUND:

Our group has developed a noninvasive blood-based microRNA (miRNA) test for improving diagnosis, disease monitoring, and relapse detection in malignant testicular germ-cell tumors (TGCTs). Performance analysis suggests the test is likely to have comparable sensitivity and specificity in detecting TGCT as computed tomography (CT), thus reducing the need for serial CT scans for follow-up monitoring, with associated reductions in cumulative radiation burden and second cancer risk. To facilitate clinical adoption, we undertook a cost analysis to identify the budget impact of replacing CT scans with miRNA testing within health care systems.

METHODS:

The TGCT aftercare pathway was mapped out using National Comprehensive Cancer Network guidelines. A Markov model was built to simulate the impact of the miRNA test on TGCT aftercare costs. Incidence, treatment probabilities, relapse rate, and death rate data were collected from published studies to populate the model.

RESULTS:

Applying our model to the US health care system, the miRNA test has the potential to save up to $69 million per year in aftercare expenses related to TGCT treatment, with exact savings depending on the adoption rate and test price.

CONCLUSION:

This analysis demonstrates the potential positive budget impact of adopting miRNA testing in place of CT scans in the clinical management of TGCTs.

KEYWORDS:

Serum; Testis cancer; miRNA

PMID:
31155478
DOI:
10.1016/j.clgc.2019.03.015

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