A collaborative value framework to assess Next-Generation Sequencing/Comprehensive Genomic Profiling diagnostic technologies

Validated and transparent value frameworks help ensure the use and reimbursement of NGS and CGP technologies is aligned with the values of all stakeholders in the healthcare system

Dr. Panos Kanavos

Project overview

As the number of new cancer cases in European countries is projected to increase by over 20% between 2020 and 2040, placing added strain on healthcare budgets, it's essential to make evidence-based resource allocation.

Next-Generation Sequencing/Comprehensive Genomic Profiling (NGS/CGP) are high-throughput sequencing technologies increasingly utilized by oncologists for rapid DNA and RNA analysis. These technologies represent a novel approach to cancer care, offering potential molecular profiling of tumors to guide therapeutic choices.

Value frameworks (VF) provide transparent and explicit criteria for decision-making, reflecting the preferences and values of various stakeholders. In 2020, IECS developed a Diagnostic Technology Value Framework tailored to diagnostic test technologies for Latin American decision-makers.

This project was a collaborative effort between researchers in the Medical Technology Research Group (MTRG) at LSE and the Institute for Clinical Effectiveness and Health Policy (IECS) in Argentina, overseen by a diverse multistakeholder steering committee. Funding was received through an unrestricted educational grant from the Precision Cancer Consortium. The sponsor had no role in the design, conduct or reporting of the research.

Team members:

IECS: Federico Augustovski, Andrea Alcaraz, Carla Colaci, Fernando Javier Argento, Veronica Alfie, Andres Pichon

LSE: Panos Kanavos, Mackenzie Mills, Danitza Chavez, Madeleine Haig, Caitlin Main.

Multistakeholder steering committee:

Panos Kanavos – London School of Economics
Federico Augustovski – Institute for Clinical Effectiveness and Health Policy
Jean Mossman – Patient advocacy (former Chief executive of CancerBACUP)
Mark Lawler – Translational Cancer Genomics / Queen´s University Belfast
Michael Drummond - Professor of Health Economics / University of York
Nicola Normanno - Italian Cancer Society
Laura Sampietro-Colom - Health Technology Assessment / Hospital Clinic Barcelona
Albrecht Stenzinger - Institute of Pathology, University Hospital Heidelberg, Germany
Benjamin Horbach (Global Leader, Market Access, Roche, representing PCC)

Objectives:

The primary goal of this research was to generate a validated collaborative value assessment framework for Next Generation Sequencing (NGS) / Comprehensive Genomic Profiling (CGP) diagnostic technologies used within the field of Oncology to a European context.

Methods:

The study, carried out between January – August 2023, consisted of mixed-methodology approach. This included a systematic review and a four-round Delphi exercise. The study was divided into three main stages:

1) Systematic review and participant identification: This initial phase consisted a systematic review to generate an initial value framework to present to participants and participant identification for the Steering committee and Delphi exercise.

2) Qualitative Delphi round one and framework adaptation: in this stage, qualitative feedback was collected on the initial framework in Delphi round one and a thematic analysis was completed effectively adapt the framework including all participant proposed themes.

3) Framework validation in Delphi rounds 2-4: the adapted framework then underwent validation through Delphi rounds two-four. In these rounds, participants were asked to rate each individual value indicator on an ‘importance’ 5-point Likert scale.

Key outputs