Dr John Fox on the Economic Value of Comprehensive Genomic Profiling

Whether or not there is economic value of comprehensive genomic profiling likely depends on what tissue type and what tumor type we’re talking about, explained John Fox, MD, MHA, vice president of Clinical Transformation at Spectrum Health.

Transcript

In addition to being able to match certain patients with cancer to targeted therapies and clinical trials, is there a cost-benefit argument that can be made for covering comprehensive genomic profiling?

Comprehensive genomic profiling has been available for a number of years now. Priority Health was one of the first health plans in the country to cover next-generation sequencing, but we covered it in very limited circumstances. In patients where there was limited tissue, especially in non-small cell lung cancer, it made more economic sense to do next-generation sequencing rather than individual tumor analyses. We covered it in patients who had poor prognosis cancers in which it was important to understand what optimal therapy was the first time around in patients who had unsuccessfully completed prior therapy and were interested in clinical trials.

So, we covered it in very limited circumstances because it was important to understand the molecular profile for making subsequent treatment decisions. I think the question of whether or not there is an economic value to testing is probably very dependent on what tissue type and what tumor type we’re talking about. We’ve published some information with Foundation Medicine about the utility of next-generation sequencing and how physicians are using that information. I think as time progresses and physicians become more experienced in using those test results, we’ll see greater utlitity.