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


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Type
Article
Change log
Authors
Charytonowicz, Daniel 
Aubrey, Harry 
Bell, Chantelle 
Ferret, Maeline 
Tsui, Keith 
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.

Description
Keywords
Serum, Testis cancer, miRNA, Biomarkers, Tumor, Costs and Cost Analysis, Follow-Up Studies, Genetic Testing, Humans, Male, Markov Chains, MicroRNAs, Neoplasm Staging, Neoplasms, Germ Cell and Embryonal, Prognosis, Survival Analysis, Testicular Neoplasms, Tomography, X-Ray Computed
Journal Title
Clin Genitourin Cancer
Conference Name
Journal ISSN
1558-7673
1938-0682
Volume Title
17
Publisher
Elsevier BV
Sponsorship
Isaac Newton Trust (1540 (f))
St Baldrick's Foundation (via Dana-Farber Cancer Institute) (2015-0743)
1) St.Baldrick’s Foundation (reference 358099) 2) Isaac Newton Trust (reference 15.40f) 3) Max Williamson Fund 4) Christiane and Alan Hodson, in memory of their daughter Olivia