ABSTRACT

Purpose: Predictive diagnostics play an increasingly important role in personalized medicine for cancer treatment. Whole-genome sequencing (WGS)-based treatment selection is expected to rapidly increase worldwide. This study aimed to calculate and compare the total cost of currently used diagnostic techniques and of WGS in treatment of non-small cell lung carcinoma (NSCLC), melanoma, colorectal cancer (CRC), and gastrointestinal stromal tumor (GIST) in the Netherlands.

Methods: The activity-based costing (ABC) method was conducted to calculate total cost of included diagnostic techniques based on data provided by Dutch pathology laboratories and the Dutch-centralized cancer WGS facility. Costs were allocated to four categories: capital costs, maintenance costs, software costs, and operational costs.

Results: The total cost per cancer patient per technique varied from € 58 (Sanger sequencing, three amplicons) to € 2925 (paired tumor-normal WGS). The operational costs accounted for the vast majority (over 90%) of the total per cancer patient technique costs.

Conclusion: This study outlined in detail all costing aspects and cost prices of current and new diagnostic modalities used in treatment of NSCLC, melanoma, CRC, and GIST in the Netherlands. Detailed cost differences and value comparisons between these diagnostic techniques enable future economic evaluations to support decision-making.

摘要

目的：预测诊断在癌症治疗的个性化医疗中发挥着越来越重要的作用。预计基于全基因组测序 (WGS) 的治疗选择将在全球范围内迅速增加。本研究旨在计算和比较荷兰目前使用的诊断技术和 WGS 治疗非小细胞肺癌 (NSCLC)、黑色素瘤、结直肠癌 (CRC) 和胃肠道间质瘤 (GIST) 的总成本。

方法：根据荷兰病理学实验室和荷兰集中的癌症 WGS 设施提供的数据，采用基于活动的成本计算 (ABC) 方法来计算包含的诊断技术的总成本。成本被分配到四类：资本成本、维护成本、软件成本和运营成本。

结果：每名癌症患者每项技术的总成本从 58 欧元（Sanger 测序，三个扩增子）到 2925 欧元（配对的肿瘤-正常 WGS）不等。运营成本占每位癌症患者技术成本的绝大部分（超过 90%）。

结论：本研究详细概述了荷兰用于治疗 NSCLC、黑色素瘤、CRC 和 GIST 的当前和新诊断方式的所有成本方面和成本价格。这些诊断技术之间的详细成本差异和价值比较使未来的经济评估能够支持决策。