Budget impact analysis of molecular subtype profiling in endometrial cancer
Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved..
OBJECTIVE: This study evaluated the costs associated with four approaches to classifying endometrial cancer (EC), including histomorphological, histomorphological with ancillary immunohistochemical assays, histomolecular and selective molecular classification.
METHODS: Direct costs were determined per EC sample from the hospital's perspective. A budget impact analysis and sensitivity analysis were conducted to estimate the mean, minimum and maximum costs per sample and annual institutional costs in adjusted 2022 Canadian dollars. A provincial cost forecast was projected based on expected 2022 EC biopsies.
RESULTS: In 2018, our institution performed 190 EC biopsies. The mean cost per biopsy was $158 ($156-$212) for histomorphological classification, $384 ($360-$514) for histomorphological classification with immunohistochemistry and $1297 ($1265-1833) for histomolecular classification. Total annual institutional cost for histomorphological classification was $29,980 and $72,950 with immunohistochemistry. For histomolecular classification, the first year cost was $246,521, accounting for initial educational learning curve, and $233,461 thereafter, assuming a consistent number of biopsies per year. Targeted implementation of histomolecular classification among high-grade, p53 abnormal and/or MMR-deficient ECs (56% of cases) cost $169,688 in the first year and $162,418 annually thereafter. With a projected 3400 EC biopsies in Ontario in 2022, histomorphological classification would annually cost $537,078 and $1,305,677 with immunohistochemistry. Histomolecular classification would cost $4,410,203 in the first year and $4,176,737 annually once established. Selective molecular classification would lead to a cost of $3,044,178 in the first year and $2,913,443 thereafter.
CONCLUSIONS: The study highlights the need for informed decision-making when implementing molecular classification in clinical practice, given the substantial incremental healthcare costs associated with these approaches.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:178 |
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| Enthalten in: |
Gynecologic oncology - 178(2023) vom: 01. Nov., Seite 54-59 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Plotkin, Anna [VerfasserIn] |
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| Links: |
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| Themen: |
Budget impact analysis |
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| Anmerkungen: |
Date Completed 20.11.2023 Date Revised 20.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ygyno.2023.09.006 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362870276 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: This study evaluated the costs associated with four approaches to classifying endometrial cancer (EC), including histomorphological, histomorphological with ancillary immunohistochemical assays, histomolecular and selective molecular classification | ||
| 520 | |a METHODS: Direct costs were determined per EC sample from the hospital's perspective. A budget impact analysis and sensitivity analysis were conducted to estimate the mean, minimum and maximum costs per sample and annual institutional costs in adjusted 2022 Canadian dollars. A provincial cost forecast was projected based on expected 2022 EC biopsies | ||
| 520 | |a RESULTS: In 2018, our institution performed 190 EC biopsies. The mean cost per biopsy was $158 ($156-$212) for histomorphological classification, $384 ($360-$514) for histomorphological classification with immunohistochemistry and $1297 ($1265-1833) for histomolecular classification. Total annual institutional cost for histomorphological classification was $29,980 and $72,950 with immunohistochemistry. For histomolecular classification, the first year cost was $246,521, accounting for initial educational learning curve, and $233,461 thereafter, assuming a consistent number of biopsies per year. Targeted implementation of histomolecular classification among high-grade, p53 abnormal and/or MMR-deficient ECs (56% of cases) cost $169,688 in the first year and $162,418 annually thereafter. With a projected 3400 EC biopsies in Ontario in 2022, histomorphological classification would annually cost $537,078 and $1,305,677 with immunohistochemistry. Histomolecular classification would cost $4,410,203 in the first year and $4,176,737 annually once established. Selective molecular classification would lead to a cost of $3,044,178 in the first year and $2,913,443 thereafter | ||
| 520 | |a CONCLUSIONS: The study highlights the need for informed decision-making when implementing molecular classification in clinical practice, given the substantial incremental healthcare costs associated with these approaches | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Budget impact analysis | |
| 650 | 4 | |a Endometiral cancer | |
| 650 | 4 | |a Lynch syndrome screening | |
| 650 | 4 | |a Molecular classification | |
| 650 | 4 | |a cancer management costs | |
| 700 | 1 | |a Olkhov-Mitsel, Ekaterina |e verfasserin |4 aut | |
| 700 | 1 | |a Nofech-Mozes, Sharon |e verfasserin |4 aut | |
| 700 | 1 | |a Djordjevic, Bojana |e verfasserin |4 aut | |
| 700 | 1 | |a Mirkovic, Jelena |e verfasserin |4 aut | |
| 700 | 1 | |a Fitzpatrick, Madeline |e verfasserin |4 aut | |
| 700 | 1 | |a Krizova, Adriana |e verfasserin |4 aut | |
| 700 | 1 | |a Look Hong, Nicole J |e verfasserin |4 aut | |
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