Moderator: Lotte Steuten, PhD, MSc, Associate Professor & Director, Health Economics, Fred Hutchinson Institute for Cancer Outcomes, Seattle, WA, USA
Panelists: Sean R Tunis, MD, MSc, Founder, Center for Medical Technology Policy, Baltimore, MD, USA; Neal Meropol, MD, Vice President of Research Oncology, Flatiron Health, New York, NY, USA; Daryl Pritchard, PhD, Senior Vice President, Personalized Medicine Coalition, Washington, DC, USA
ISSUE: NGS-based diagnostic testing compared to single-marker genetic testing (SMGT), has the potential to improve testing efficiency and to identify more cancer patients who could benefit from targeted therapies, but the impact on outcomes and total costs of care is uncertain. Recent studies using simulation modeling informed with data from the Flatiron Health database, representing curated electronic health record-derived clinical information from 191 oncology practices, has shown only moderate cost effectiveness of NGS vs. SGMT for patients with advanced non-small cell lung cancer (aNSCLC). The data suggests, however, that efforts to increase the proportion of patients who receive targeted therapies would improve the cost-effectiveness of NGS. To effectively inform access and reimbursement policy decisions there is a need to examine the NGS value proposition from the perspective of all stakeholders.
OVERVIEW: This panel will debate the value proposition for the use of NGS-based Dx testing for cancer care using aNSCLC as an example. Lotte Steuten will moderate the panel and provide an overview of the current landscape of evidence of clinical and cost effectiveness of NGS testing in aNSCLC, and will pose key questions for the panelists to debate: Is NGS a cost-effective alternative to SMGT? Should payers and providers provide access to patients? What are potential practice and policy considerations that can be addressed to ensure realization of the full value potential of NGS? Sean Tunis will discuss balancing costs and access from a payer perspective, and the need for real world evidence. Daryl Pritchard will make the case for NGS as the key to more effective cancer care as more targeted therapies advance to the market and will argue for the need for positive patient access policies. Neal Meropol will discuss what is necessary for evidence generation, and how real-world data can help reveal practice gaps.