Table 25:

Budget Impact in Sensitivity Analysis

Scenarios Assessed	Budget Impact, $ Milliona
	Year 1	Year 2	Year 3	Year 4	Year 5	Totalb,c
Reference Case
Budget impact	3.50	7.04	10.50	13.77	16.75	51.55
Budget impact: cost of testing	4.84	9.73	14.52	19.05	23.17	71.31
Scenario 1a: Uptake of Multi-gene Pharmacogenomic Testing: Increment of 3% per Year (Year 1, 3%; Year 5, 15%)
Budget impact	10.49	20.69	29.64	36.54	40.86	138.21
Budget impact: cost of testing	14.51	28.62	41.00	50.55	56.52	191.20
Scenario 1b: Uptake of Multi-gene Pharmacogenomic Testing: Increment of 5% per Year (Year 1, 15%; Year 5, 35%)
Budget impact	17.48	33.78	46.39	53.53	54.64	205.82
Budget impact: cost of testing	24.18	46.73	64.17	74.06	75.58	284.72
Scenario 2a: Expansion of reference case target population to treatment-naive population only
Budget impact	1.20	2.42	3.61	4.73	5.76	17.72
Budget impact: cost of testing	1.66	3.35	4.99	6.55	7.96	24.51
Scenario 2b: Expansion of reference case target population to people who have not responded to at least one medication
Budget impact	5.83	11.73	17.50	22.95	27.91	85.91
Budget impact: cost of testing	8.06	16.22	24.21	31.75	38.61	118.85
Scenario 2c: Expansion of reference case target population to include both groups
Budget impact	7.03	14.14	21.11	27.69	33.67	103.63
Budget impact: cost of testing	9.72	19.57	29.20	38.30	46.57	143.36
Scenario 3a: Price of multi-gene pharmacogenomic test reduced to lower-end price of $450
Budget impact	–0.27	–0.53	–0.80	–1.05	–1.27	–3.92
Budget impact: cost of testing	1.07	2.16	3.23	4.23	5.15	15.85
Scenario 3b: Price of multi-gene pharmacogenomic test reduced by 25% of reference case price (to $1,875)
Budget impact	2.35	4.73	7.06	9.26	11.26	34.65
Budget impact: cost of testing	3.69	7.43	11.08	14.54	17.68	54.41
Scenario 3c: Price of multi-gene pharmacogenomic test reduced by 50% of reference case price (to $1,250)
Budget impact	1.20	2.42	3.61	4.74	5.76	37.50
Budget impact: cost of testing	2.54	5.12	7.64	10.02	12.18	37.50
Scenario 3d: Price of multi-gene pharmacogenomic test ($2,161) if threshold for cost-effectiveness of intervention is achieved
Budget impact	2.88	5.79	8.64	11.33	13.78	42.41
Budget impact: cost of testing	4.22	8.48	12.66	16.61	20.20	62.17
Scenario 3e: Price of multi-gene pharmacogenomic test ($595) if cost saving threshold is achieved
Budget impact	0.00	0.00	0.00	0.00	0.00	0.00
Budget impact: cost of testing	1.34	2.70	4.03	5.28	6.42	19.77
Scenario 4a: Clinical visits associated with testing: no additional visits are needed (testing incorporated in current care)
Budget impact	3.25	6.54	9.76	12.80	15.56	47.90
Budget impact: cost of testing	4.59	9.23	13.78	18.08	21.98	67.66
Scenario 4b: Clinical visits associated with testing: one additional visit is needed
Budget impact	3.37	6.79	10.13	13.29	16.16	49.73
Budget impact: cost of testing	4.71	9.48	14.15	18.56	22.58	69.49
Scenario 4c: Clinical visits associated with testing: 3 additional visits are needed
Budget impact	3.62	7.29	10.88	14.27	17.35	53.40
Budget impact: cost of testing	4.96	9.98	14.90	19.54	23.77	73.16
Scenario 5: Inclusion of OHIP+ pharmacogenomic-guided treatment coverage for youth and young adults
Budget impact	13.72	23.49	25.12	20.76	16.80	99.89
Budget impact: cost of testing	18.98	32.50	34.74	28.72	23.24	138.17

^aAll costs are in 2020 Canadian dollars.

^bNegative costs indicate savings.

^cResults might appear incorrect because of rounding.