Table 3.
Types of evidence for MCED outcomes that payers need for coverage considerations and which types would be decisive factors in coverage decisions.
| Evidence categories and types of evidence | Percent (n/N) of payers who will need this evidence for coverage decisionsa (N = 19) | Percent (n/N) of payers for whom this evidence will be a decisive factor in coverage decisionsb (N = 19) |
|---|---|---|
| Screening endpoints | ||
| Uptake of MCED | 26 (5/19) | 0 |
| Changes in adherence to recommended screening as a result of using MCED | 21 (4/19) | 0 |
| Diagnosis endpoints | ||
| Impact on stage at diagnosis | 84 (16/19) | 16 (3/19) |
| Number to screen to get one cancer diagnosis | 21 (4/19) | 0 |
| NPV, PPV | 26 (5/19) | 0 |
| Clinical care endpoints | ||
| Survival | 42 (8/19) | 42 (8/19) |
| Net clinical outcome: survival and harms from increased morbidity and/or treatment toxicity | 21 (4/19) | 21 (4/19) |
| Survival only | 21 (4/19) | 21 (4/19) |
| Reduction in disease morbidity and/or treatment toxicity | 37 (7/19) | 37 (7/19) |
| Impact on patient anxiety | 26 (5/19) | 0 |
| Healthcare factors | ||
| Cost | 47 (9/19) | 5 (1/19) |
| Patient and clinician satisfaction | 11 (2/19) | 0 |
Note: MCED = multicancer early-detection; NPV = negative predictive value; PPV = positive predictive value.
a
This column does not amount to 100% as some payers noted the need for multiple types of evidence.
b
This column amounts to 100% as each payer named one type of evidence that would be decisive for coverage.