TABLE IV.
Health and budget impacts by scenarioa
| Scenario and variable | Reference scenario 1: Single-gene testing only | Reference scenario 2: Single-gene testing plus hotspot panel | ||||||
|---|---|---|---|---|---|---|---|---|
|
|
|
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| Overall | Year 1 | Year 2 | Year 3 | Overall | Year 1 | Year 2 | Year 3 | |
| Reference scenario costs ($M) | 343.3 | 61.0 | 114.5 | 167.8 | 356.9 | 65.5 | 119.0 | 172.3 |
| Adoption scenario 1: FoundationOne CDx replaces all reflex tests | ||||||||
|
| ||||||||
| Incremental budget impact ($M) | 37.1 | 12.4 | 12.3 | 12.3 | 30.3 | 10.1 | 10.1 | 10.1 |
|
| ||||||||
| Incremental budget impact PMPY ($) | 0.87 | 0.87 | 0.87 | 0.87 | 0.71 | 0.71 | 0.71 | 0.71 |
|
| ||||||||
| Incremental overall survival (years) | 680.9 | 54.9 | 273.2 | 352.8 | 680.9 | 54.9 | 273.2 | 352.8 |
|
| ||||||||
| Incremental working days | 3831 | 784 | 1524 | 1524 | 3831 | 784 | 1524 | 1524 |
|
| ||||||||
| NNT to gain 1 life–year | 174 Patients | 174 Patients | ||||||
|
| ||||||||
| Adoption scenario 2: FoundationOne CDx replaces hotspot panel | ||||||||
|
| ||||||||
| Incremental budget impact ($ million) | Not applicable | 28.7 | 9.6 | 9.5 | 9.5 | |||
|
| ||||||||
| Incremental budget impact PMPY ($) | 0.67 | 0.68 | 0.67 | 0.67 | ||||
|
| ||||||||
| Incremental overall survival (years) | 460.0 | 34.5 | 180.6 | 245.0 | ||||
|
| ||||||||
| Incremental working days | 2597 | 492 | 1053 | 1053 | ||||
|
| ||||||||
| NNT to gain 1 life–year | 250 Patients | |||||||
|
| ||||||||
| Adoption scenario 3: FoundationOne CDx after negative reflex testing and hotspot panel | ||||||||
|
| ||||||||
| Incremental budget impact ($ million) | Not applicable | 23.6 | 7.9 | 7.9 | 7.9 | |||
|
| ||||||||
| Incremental budget impact PMPY ($) | 0.56 | 0.56 | 0.55 | 0.55 | ||||
|
| ||||||||
| Incremental overall survival (years) | 291.0 | 22.4 | 115.1 | 153.5 | ||||
|
| ||||||||
| Incremental working days | 1641 | 320 | 661 | 661 | ||||
|
| ||||||||
| NNT to gain 1 life–year | 399 Patients | |||||||
|
| ||||||||
| Adoption scenario 4: FoundationOne Liquid only | ||||||||
|
| ||||||||
| Incremental budget impact ($ million) | 4.4 | 1.5 | 1.5 | 1.5 | 4.4 | 1.5 | 1.5 | 1.5 |
|
| ||||||||
| Incremental budget impact PMPY ($) | 0.10 | 0.10 | 0.10 | 0.10 | 0.10 | 0.10 | 0.10 | 0.10 |
|
| ||||||||
| Incremental overall survival (years) | 132.1 | 12.7 | 56.1 | 63.3 | 132.1 | 12.7 | 56.1 | 63.3 |
|
| ||||||||
| Incremental working days | 736 | 181 | 277 | 277 | 736 | 181 | 277 | 277 |
|
| ||||||||
| NNT to gain 1 life–year | 968 Patients | 968 Patients | ||||||
a
Scenarios 1–3 assume 50% uptake for FoundationOne CDx (Foundation Medicine, Cambridge, MA, U.S.A.).
$M = millions of dollars; PMPY = per member per year; NNT = number needed to treat.