In the ever-evolving landscape of oncology diagnostics, health economics plays a crucial role in determining the feasibility and implementation of new technologies. Clinical benefits and cost-effectiveness are at the forefront of these decisions, shaping the future of cancer treatment and patient care. A recent study published in the Journal of Therapeutics Advancements of Gastroenterology titled, "Explorative cost-effectiveness analysis of colorectal cancer recurrence detection with next-generation sequencing liquid biopsy in Spain, France, and Germany" [1], highlights the promising potential of next-generation sequencing-based liquid biopsy (NGS-LB) for patient care.

Researchers Prof. Dr Wendelin Schramm, Dr Yasmin Hollenbenders, and M.Sc Maximilian Kurscheidt from the GECKO Institute for Medicine, Informatics and Economics at Hochschule Heilbronn, Germany, discussed the economic and clinical potential of NGS-LB for detecting colorectal cancer (CRC) recurrence. Their findings reveal that NGS-LB achieves generally accepted cost-effectiveness (CE) levels in CRC treatment, even when modest clinical improvements in cancer recurrence and survival rates are observed. A modest 1% to 3% improvement in survival and disease progression led to favourable CE results, demonstrating that the cost per quality-adjusted life-year (QALY) gained is within acceptable ranges compared to willingness-to-pay (WTP) thresholds in many developed healthcare systems.

The study also uncovers significant country-specific insights, NGS-LB remains a cost-effective option even in higher-cost healthcare systems such as Germany, the country with the highest total direct costs (TDC). Despite these promising results, the authors stress the need for prospective clinical trials to validate their findings and ensure robust clinical data.

To further discuss practical implications of liquid biopsy technology, the LIQUID BIOPSY IMPACT had the pleasure to speak with one of the authors of this study, Prof. Dr. Wendelin Schramm, a leading expert in the field. In this interview, Prof. Dr. Schramm shares his in-depth insights into the future of NGS-LB within clinical settings, its current challenges and what needs to be done to bring this revolutionary technology from the lab to widespread clinical use.

Impact: Considering the high cost of cancer therapy, how can liquid biopsies reduce expenses?

Prof. Dr. Schramm: As demonstrated, one can use liquid biopsy testing to avoid costly therapies. That is an immediate level for cost-effectiveness and important for reimbursement in the healthcare system. Another aspect is the standardisation of laboratory processes, making them quicker and of higher quality. Additionally, liquid biopsy could potentially detect relapses earlier, allowing for less intensive treatment and better quality of life for patients. It can keep patients longer in a certain disease stage and hopefully reduce overall mortality of cancer. In the end, it's a contribution to mortality that liquid biopsy will have to demonstrate.

Impact: Given those potential advantages, what do you think needs to be done to integrate liquid biopsies into routine clinical practice?

Prof. Dr. Schramm: In my perception, we will see a trend towards more standardisation and validation of the test processes and methods. This is the prerequisite to expand this technology to more laboratories. Currently, liquid biopsy is still in the scientific domain, and the big challenge will be to bring this technology to patients.

Impact: Do you think that kit-based solutions could help with this expansion?

Prof. Dr. Schramm: Yes, of course. I think test kits are a really helpful method to standardise the working process within the lab. Test kits allow for automation, reducing the individual influence of personnel in a laboratory and raising the quality. Quality assurance will be one of the decisive factors to bring this technology to the market.

Impact: What other factors might affect the availability of liquid biopsies?

Prof. Dr. Schramm: The big hurdle is reimbursement. If reimbursement means that the liquid biopsy is part of the payment catalogue of our public healthcare system, patients have a right to get this if they fulfil certain criteria. To achieve this, it is mandatory to demonstrate the success of liquid biopsy not only in terms of improved survival, but also improved quality of health for people with cancer, less disease burden and fewer side effects. These are the most important factors.

Impact: Can you summarise where we are now with liquid biopsy testing and its future role?

Prof. Dr. Schramm: Currently, we are on the the edge of leaving the bench and going to the healthcare market. Liquid biopsy, especially next-generation liquid biopsy, has already clinical benefits. A prerequisite for success in healthcare markets will be to standardise the laboratory processes and ensure quality assurance. More laboratories require access to this technology in a cost-effective manner without compromising quality.

Impact: Thank you for your insights.

Discover the full details and in-depth analysis of liquid biopsy's cost-effectiveness in colorectal cancer recurrence by reading the complete study on PubMed: Explorative cost-effectiveness analysis of colorectal cancer recurrence detection with next-generation sequencing liquid biopsy in Spain, France, and Germany - PubMed (nih.gov)