Evaluating Cost Effectiveness of Precision Cancer Medicine Approaches and The Economic Burden of Colorectal Cancer
type: CreativeWork
description: As the understanding of the biology of cancer intensifies, biomarkers with the potential to guide precision cancer medicine (PCM) are discovered with increasing regularity. Yet the cost-effectiveness of the biomarker-guided PCM strategy is rarely evaluated. Utilising colorectal cancer (CRC) as a bellwether for PCM implementation, I conducted a systematic review of health economic analyses of molecular biomarkers (MBM) to stratify CRC patients for PCM in high-income countries. This analysis found that: 1.Oncotype DX® is cost-effective in sparing treatment toxicity. 2.Dihydropyrimidine dehydrogenase gene (DPYD) status testing may be cost-effective to avoid 5-Fluorouracil (5-FU) toxicity. 3.Uridine 5’-diphospho-glucuronosyltransferase family 1 member A1 gene (UGT1A1) polymorphism status is not cost-effective in guiding irinotecan dosing. 4.The cost effectiveness of testing of KRAS/NRAS mutational status for guiding cetuximab or panitumumab therapy is inconclusive. Overall, the systematic review revealed that there was a paucity of cost-effectiveness studies in CRC to support biomarker-enriched PCM approaches. To discern the real-world impact that PCMs and other therapeutic modalities are having on CRC survival, the economic burden of CRC in Europe for the year 2015 was determined by an enhanced cost-of-illness study, covering the EU27, together with the United Kingdom, Iceland, Norway, Switzerland, Serbia and Turkey (EUR33). CRC costs in 2015 were €21.9bn, broken down as follows: healthcare costs: €7bn (32% of overall costs); mortality costs: €5.7bn (26%); morbidity costs: €7bn (32%); informal care costs: €2.2bn (10%). Costs for managing a CRC patient varied significantly across each country, as did hospital care costs. Amongst overall healthcare costs, pharmaceutical costs represented the second largest expenditure after hospital care costs, and in several countries pharmaceutical costs were higher than hospital costs. The proportion of total healthcare expenditure on…
abstract: As the understanding of the biology of cancer intensifies, biomarkers with the potential to guide precision cancer medicine (PCM) are discovered with increasing regularity. Yet the cost-effectiveness of the biomarker-guided PCM strategy is rarely evaluated. Utilising colorectal cancer (CRC) as a bellwether for PCM implementation, I conducted a systematic review of health economic analyses of molecular biomarkers (MBM) to stratify CRC patients for PCM in high-income countries. This analysis found that: 1.Oncotype DX® is cost-effective in sparing treatment toxicity. 2.Dihydropyrimidine dehydrogenase gene (DPYD) status testing may be cost-effective to avoid 5-Fluorouracil (5-FU) toxicity. 3.Uridine 5’-diphospho-glucuronosyltransferase family 1 member A1 gene (UGT1A1) polymorphism status is not cost-effective in guiding irinotecan dosing. 4.The cost effectiveness of testing of KRAS/NRAS mutational status for guiding cetuximab or panitumumab therapy is inconclusive. Overall, the systematic review revealed that there was a paucity of cost-effectiveness studies in CRC to support biomarker-enriched PCM approaches. To discern the real-world impact that PCMs and other therapeutic modalities are having on CRC survival, the economic burden of CRC in Europe for the year 2015 was determined by an enhanced cost-of-illness study, covering the EU27, together with the United Kingdom, Iceland, Norway, Switzerland, Serbia and Turkey (EUR33). CRC costs in 2015 were €21.9bn, broken down as follows: healthcare costs: €7bn (32% of overall costs); mortality costs: €5.7bn (26%); morbidity costs: €7bn (32%); informal care costs: €2.2bn (10%). Costs for managing a CRC patient varied significantly across each country, as did hospital care costs. Amongst overall healthcare costs, pharmaceutical costs represented the second largest expenditure after hospital care costs, and in several countries pharmaceutical costs were higher than hospital costs. The proportion of total healthcare expenditure on…
author: Henderson, Raymond
language: eng
keywords: Economic evaluation, Precision medicine, Colorectal cancer
date published: 2019-12
date modified: 2026-07-24T03:55:12Z
provider: Queen's University Belfast
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Queen's University Belfast