Comparison of utility cost in three commercially available precision medicine approaches in Oncology


Kenneth Russell, Jaak Janssens, Andrew Dean, William Gallagher, Alejandro Hernandez, Andreas Voss, Gordon Stamp


The introduction of molecular profiling as standard of care in cancer has led to the launch of a number of commercial precision medicine services, which differ largely in their approaches. It can be difficult for payers, physicians, and patients to distinguish between these services and determine which testing is most appropriate for an individual case. An understanding of the clinical utility and the utility cost (cost of finding one patient with clinical benefit) of the different approaches can help to set expectations for all stakeholders involved.


The aim of this study is to define the utility cost of three leading commercially available oncology precision medicine approaches, Caris Molecular Intelligence® (CMI), FoundationOne® and PCDx™.


A systematic review of all published clinical evidence for the three services was performed, to determine the number of patients treated in line with the profiling results and the clinical benefit resulting from these treatment choices. Utility cost was defined as the list price divided by the fraction of patients treated based upon the profiling results and the clinical benefit in treated patients.


Based on the number of profiled patients treated and the corresponding number of patients with clinical benefit, 34% of CMI-profiled patients had clinical benefit (184 of 534 profiled patients), compared to 6% of those profiled with FoundationOne® (166 of 2,675 profiled patients) and 11% profiled using PCDx™ (19 of 168 profiled patients). Utility cost was calculated as $19,118 for CMI, $43,636 for
PCDx™ and $96,667 for FoundationOne®.


The results of this study shows that the multiplatform approach of CMI brings the highest clinical utility, based on the use of conventional chemotherapies in the majority of patients profiled. A low clinical utility means that almost 20 cases of FoundationOne® must be purchased to find one patient who benefits.

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