Abstract 5490: Implementation of genetic sequencing in breast and ovarian cancer patients: a cost analysis
Authors: Olson Marissa A. , Tutera Seth , Williams Casey 
Published: August 2015

Abstract
Purpose: Genetic sequencing has the ability to identify and treat the driving mechanisms of cancer. As a result, practitioners can individualize treatment to each patient's tumor. A major concern with genetic sequencing is the cost associated with targeted therapies. The purpose of this analysis is to explore the financial impact of genetic sequencing and targeted therapy in the treatment of breast and ovarian cancer.
Methods: A systematic search was conducted of patients that underwent genetic sequencing. Five metastatic ovarian cancer patients and five metastatic breast cancer patients were selected at random. One breast cancer patient that underwent neoadjuvant sequencing was also selected. The data analyzed included patients’ previous treatment regimens, potential next line therapy based on the National Comprehensive Cancer Network (NCCN) guidelines, and genomic sequencing based treatment regimens. The direct medication costs were calculated based on Cardinal Health's average wholesale price. Non-drug related treatment (radiation, surgery, etc.), outpatient costs, inpatient costs, and non-chemotherapeutic medications were excluded from the analysis.
Results: The five metastatic breast cancer patients each spent an average of $195,838.22 on chemotherapeutic agents during the course of their treatment. This totals to an average of $5,287.56 per month of treatment. The average cost of the potential next line therapy based on NCCN guidelines was approximately $11,597.58 per month. The average cost of an individualized genomic-based treatment regimen for each breast cancer patient approximated at $19,202.90. The breast cancer patient who underwent neoadjuvant genetic sequencing and treatment spent a total of $57,196.38 that was approximately $11,439.38 per month. If the patient had received the standard of care based on the NCCN guidelines the cost would have been $17,283.95 or $3,456.79 per month. The average total cost of the treatment regimens received by five metastatic ovarian cancer patients was $155,050.99 and approximately $6,385.70 per month of treatment. The cost per month of potential next line therapy in these patients was about $11,704.98. The average cost of a genomic-based treatment regimen for each patient would cost approximately $7,542.82 per month.
Discussion: It is evident that genomic-based treatment regimens are more expensive on average than the traditional standard of care. However, in the metastatic setting, patients are spending exponential amounts of money over their lifetime. Often times, they are continuously cycling through expensive treatments that are ineffective in treating the cancer's driving mechanism. Overall, genomic-based treatment has the potential for a high return on investment due to its ability to directly target the mutations causing a patient's malignancy. Further research is needed to assess the outcomes associated with genomic-based treatment.
Citation Format: Marissa A. Olson, Seth Tutera, Casey Williams. Implementation of genetic sequencing in breast and ovarian cancer patients: a cost analysis. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 5490. doi:10.1158/1538-7445.AM2015-5490