Personalized Treatment of Lymphoid Cancer: British Columbia as Model Province
Developing a new method for guiding patient treatment - such as genomic profiling/sequencing and subsequent personalization of cancer treatment - necessarily involves a novel mix of resource utilization. To determine the cost impact and cost savings of improvement in treatment outcome as a result of genomic profiling, robust cost effectiveness analyses will be conducted as part of this project. The research questions that pertain to this specific part of the larger research study - Deliverables 3-5 - are outlined below:
What is the pattern of resource utilization experienced by lymphoma patients in current practice in British Columbia's health care system?
What is the cost impact and what are the potential cost savings from implementing cross-provincial personalized lymphoid cancer treatment?
What are some of the key drivers of cost and savings?
Lymphoid cancer management guided by genomic profiling has two potential economic consequences. First, by identifying subpopulations of patients that will not respond to certain types of drugs or other medical interventions, there may be a reduction in health care expenditure on treatments from which patients do not derive benefit, avoiding unnecessary and expensive treatment. Alternatively, by identifying populations with particularly favorable responses to standard treatment, it may be possible to reduce treatment and treatment-associated costs without forfeiting treatment benefit. Second, use of genomic markers may result in quality of life and survival benefits for patients, either by determining eligibility for novel medical interventions (i.e., drugs that target a specific gene expression pathway) or by identifying those who are in need of additional adjuvant care (e.g., intensified chemotherapy regimens).
Resource utilization of lymphoid cancers (specifically the four most common lymphoid cancers - diffuse large B cell lymphoma, follicular lymphoma, Hodgkin lymphoma, and chronic lymphocytic leukemia) will depend on factors such as age, sex, clinical stage, and other standard prognostic factors. For the purposes of this research study, we require an accurate description of costs experienced by comparable control groups for these four types of lymphoma cancer patients who have already undergone treatment to establish a sound baseline of resource utilization patterns prior to implementation of these new genomic analytic tools. Economic modeling and statistical techniques will be applied during the model building and analysis stages to ensure we account for any uncertainties related to treatment and/ or costs of these new analytic techniques to current practice.
- Costa S, Connors JM, Cromwell I, Peacock SJ, Regier DA. Health economic analysis of genomic-informed approaches for management of lymphoid cancer in British Columbia. Canadian Centre for Applied Research in Cancer Control Conference, Toronto, ON, May 2017. [podium presentation]
- Regier DA, Costa S, Scott DW, Cromwell I, Peacock SJ, Connors JM. Cost-effectiveness of molecularly-guided targeted treatment in diffuse large b-cell lymphoma. International Health Economics Association (iHEA) 2017 Bi-Annual World Congress, Boston, MA, July 2017. [podium presentation]
- 2 presentations:
A cost-effectiveness evaluation of ibrutinib for relapsed chronic lymphocytic leukemia (CLL) in British Columbia.
Society for Medical Decision Making (SMDM) 38th Annual North American Meeting. Vancouver, BC. Oct 23-26, 2016
Costa S, Cromwell I, Connors JM, Scott DW, Peacock SJ, Regier DA. A cost-effectiveness evaluation of ibrutinib for relapsed chronic lymphocytic leukemia (CLL) in British Columbia. Terry Fox Research Institute BC Node Research Day, Vancouver, BC, October 2016. [poster presentation]
- Costa S, Regier DA, Scott DW, Cromwell I, Steidl C, Peacock SJ, Connors JM. A cost-effectiveness evaluation of Ibrutinib for the treatment of diffuse large B-cell lymphoma (DLBCL) in British Columbia. Canadian Centre for Applied Research in Cancer Control Conference, Toronto, ON, May 2016. [poster presentation]