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Cost-effectiveness of a new autoantibody test added to Computed Tomography (CT) compared to CT surveillance alone in the diagnosis of lung cancer amongst patients with indeterminate pulmonary nodules

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  • Andrew John Sutton
  • Gurdeep S Sagoo
  • Leon Jackson
  • Mike Fisher
  • Geoffrey Hamilton-Fairley
  • Andrea Murray
  • Adam Hill

Abstract

Oncimmune's EarlyCDT®-Lung is a simple ELISA blood test that measures seven lung cancer specific autoantibodies and is used in the assessment of malignancy risk in patients with indeterminate pulmonary nodules (IPNs). The objective of this study was to examine the cost-effectiveness of EarlyCDT-Lung in the diagnosis of lung cancer amongst patients with IPNs in addition to CT surveillance, compared to CT surveillance alone which is the current recommendation by the British Thoracic Society guidelines. A model consisting of a combination of a decision tree and Markov model was developed using the outcome measure of the quality adjusted life year (QALY). A life-time time horizon was adopted. The model was parameterized using a range of secondary sources. At £70 per test, EarlyCDT-Lung and CT surveillance was found to be cost-effective compared to CT surveillance alone with an incremental cost-effectiveness ratio (ICER) of less than £2,500 depending on the test accuracy parameters used. It was also found that EarlyCDT-Lung can be priced up to £1,177 and still be cost-effective based on cost-effectiveness acceptance threshold of £20,000 / QALY. Further research to resolve parameter uncertainty, was not found to be of value. The results here demonstrate that at £70 per test the EarlyCDT-Lung will have a positive impact on patient outcomes and coupled with CT surveillance is a cost-effective approach to the management of patients with IPNs. The conclusions drawn from this analysis are robust to realistic variation in the parameters used in the model.

Suggested Citation

  • Andrew John Sutton & Gurdeep S Sagoo & Leon Jackson & Mike Fisher & Geoffrey Hamilton-Fairley & Andrea Murray & Adam Hill, 2020. "Cost-effectiveness of a new autoantibody test added to Computed Tomography (CT) compared to CT surveillance alone in the diagnosis of lung cancer amongst patients with indeterminate pulmonary nodules," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-16, September.
    • Handle: RePEc:plo:pone00:0237492
    DOI: 10.1371/journal.pone.0237492
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    References listed on IDEAS

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    1. Mark Strong & Jeremy E. Oakley & Alan Brennan, 2014. "Estimating Multiparameter Partial Expected Value of Perfect Information from a Probabilistic Sensitivity Analysis Sample," Medical Decision Making, , vol. 34(3), pages 311-326, April.
    2. John Edelsberg & Derek Weycker & Mark Atwood & Geoffrey Hamilton-Fairley & James R Jett, 2018. "Cost-effectiveness of an autoantibody test (EarlyCDT-Lung) as an aid to early diagnosis of lung cancer in patients with incidentally detected pulmonary nodules," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-14, May.
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