Cost-Effectiveness of a Bronchial Genomic Classifier for the Diagnostic Evaluation of Lung Cancer

Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer
David Feller-KopmanJan B Pietzsch

Abstract

The use of a bronchial genomic classifier has been shown to improve the diagnostic accuracy of bronchoscopy for suspected lung cancer by identifying patients who may be more suitable for radiographic surveillance as opposed to invasive procedures. Our objective was to assess the cost-effectiveness of bronchoscopy plus a genomic classifier versus bronchoscopy alone in the diagnostic work-up of patients at intermediate risk for lung cancer. A decision-analytic Markov model was developed to project the costs and effects of two competing strategies by using test performance from the Airway Epithelial Gene Expression in the Diagnosis of Lung Cancer-1 and Airway Epithelial Gene Expression in the Diagnosis of Lung Cancer-2 studies. The diagnostic accuracy of noninvasive and invasive follow-up, as well as associated adverse event rates, were derived from published literature. Procedure costs were based on claims data and 2016 inpatient and outpatient reimbursement amounts. The model projected the number of invasive follow-up procedures, 2-year costs and quality-adjusted life-years (QALYs) by strategy, and resulting incremental cost-effectiveness ratio discounted at 3% per annum. Use of the genomic classifier reduced invasive procedures...Continue Reading

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Citations

Apr 13, 2019·International Journal of Cancer. Journal International Du Cancer·Elvira D'AndreaMehdi Najafzadeh
Feb 22, 2018·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Ehab BillatosAvrum E Spira
Oct 24, 2020·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Edwin J OstrinSamir M Hanash
Mar 19, 2021·Journal of Bronchology & Interventional Pulmonology·Krish BhadraMichael A Pritchett

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