Life Years Gained and Healthcare Dollars Saved: National Economic Evidence Supporting Comprehensive Genomic Profiling as Standard of Care for Canadian Cancer Patients
Simple Summary
Abstract
1. Introduction
2. Economic Evidence Supports CGP as Standard of Care for Individuals with Metastatic Cancer
2.1. Findings from the National Costs and Benefits Analysis of CGP as SOC
- Actionable biomarker identification rate for CGP: 32% [19];
- Matched therapy administration rate for CGP when a biomarker is identified: 43% [19];
- Actionable biomarker identification rate for alternative testing: 14% [19];
- Matched therapy administration rate for alternative testing when a biomarker is identified: 38% [19];
- Increase in overall survival from receiving CGP: eight months [19].
- Due to the lack of Canadian data regarding the clinical utility and application of CGP for de novo Stage IV cancers, related assumptions were based on a combination of peer-reviewed data (where available) and expert opinion. Data for NSCLC was used as a proxy for other cancer types where insufficient data were available to compare the rate of identifying actionable biomarkers, receiving matched therapies, and overall survival between CGP-NGS and current single biomarker testing for each stage IV disease and panel type.
- Treatment costs reflect publicly available data rather than real-world hospital pricing that may have included possible discounts.
- Estimates on the proportion of patients receiving each therapy, and subsequent attrition, were derived from expert opinion (oncologists from each cancer specialty), which may have created inconsistencies due to varying treatment choices across Canadian provinces and territories.
Long-Term Medical and Economic Value of CGP as SOC
- Data-driven health systems will generate evidence for clinical and research use [24], and realize the potential of large CGP panels through the identification of other actionable mutations, accelerating the increase in CGP’s clinical utility for tumour types for which CGP is not currently cost-effective.
- Utility will further increase as (i) novel biomarkers emerge, particularly for cancers where CGP previously had limited value, and (ii) indications for existing targeted therapies expand to include new tumour types.
- Identification of specific patient populations for whom potentially toxic suboptimal “standard” therapies offer little benefit will avoid healthcare system funds being inappropriately spent on the “one size fits all” approach to prescribing that exists when CGP testing is unavailable altogether or subject to access delays.
- Population-level CGP data within the diverse Canadian landscape population is likely to hold economic value for industry, directing future rounds of cancer therapy research and development.
3. Advancing Towards CGP as Standard of Care
3.1. Canada’s State of Readiness for Implementation of Genome-Based Testing Programmes
International Experiences with Adoption of CGP
3.2. Facilitators of CGP Program Implementation
3.2.1. Enhancing Clinician Awareness and Knowledge of CGP
3.2.2. Expedited Turnaround Time for CGP Results
3.2.3. Incorporating Partnerships into Decision-Making Towards Implementation
- The Alberta Diagnostic Ecosystem Platform for Translation (ADEPT) is a translational research programme that provides clinical samples and related data to commercial innovators of diagnostic tools and platforms [40]. While programmes such as ADEPT do not guarantee such laboratory technology will have widespread adoption, they can support the generation of evidence needed to facilitate uptake. Additionally, other provinces can leverage findings.
- Genome Canada, an independent and federally funded not-for-profit organization, founded the Canadian Precision Health Initiative (CPHI), a PPP programme supported by the Government of Canada with investments from industry, academia and public sector partners [41]. The CHPI funded 12 foundation projects (including oncology projects) to generate large-scale data, mobilize and advance the utility of genomic health datasets.
- Healthy Outcomes Through Genomic Innovations, a Genome Alberta and Genome British Columbia programme focuses on PPP solutions to accelerate the equitable adoption of genomic testing into routine clinical care [42].
4. Conclusions
- Collaboration must be facilitated between regulators, payers and industry to identify regional differences in current access to CGP, and to create a cohesive national strategy to implement CGP as SOC for all individuals with metastatic cancer. Inter-provincial and territorial efforts as well as the further development of PPPs will be critical to eliminate variation in access to and availability of timely CGP, enhance physician prescribing flexibility and share best practices in adopting innovation.
- Funding should be allocated so that CGP is first publicly covered for the five tumour types that contribute to the highest cancer-related mortality (lung, CRC, pancreas, breast, and prostate). This initial investment will build the foundation within the public health system that will provide the proof-of-concept evidence needed to demonstrate the clinical utility of CGP, and serve as the impetus for program extension to other tumour types as emerging biomarkers are realized.
- Investment in CGP education for oncologists and other healthcare providers is needed to ensure that these providers stay current on important advancements in precision medicine. Pathways include ongoing continuing medical education (CME) on how to interpret CGP results, facilitation of improved interprofessional collaboration between pathology and oncology professionals, and enacting on-site or virtual molecular tumour boards in cancer centres and regional hospitals to provide support and knowledge on patient cases.
- Investment in laboratory medicine infrastructure and health human resources is critical to improving equitable and timely access to CGP and results.
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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| FoundationOne CDx (324 Gene) | Oncomine Precision Assay (50 Gene) | AmpliSeq Focus Panel (52 Gene) | Oncomine Comprehensive Assay V3 (161 Gene) | |
|---|---|---|---|---|
| Lung cancer | −$131 | $1075 | $933 | $715 |
| Colorectal cancer | −$306 | $2495 | $2138 | $1677 |
| Pancreatic cancer | −$730 | $1751 | $1560 | $1161 |
| Breast cancer | −$770 | $272 | $130 | $4 |
| Prostate cancer | −$639 | $392 | $250 | $130 |
| CGP | Current SOC | |
|---|---|---|
| Lung cancer | 5933 | 4114 |
| Colorectal cancer | 2503 | 1735 |
| Pancreatic cancer | 1342 | 930 |
| Breast cancer | 447 | 310 |
| Prostate cancer | 991 | 687 |
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Snow, S.; Banerji, S.; Bombard, Y.; Husereau, D.; Karamchandani, J.; Nason, E.; Ohashi, P.S.; van Rooijen, G.; Vainer, G.; Macaulay, C.; et al. Life Years Gained and Healthcare Dollars Saved: National Economic Evidence Supporting Comprehensive Genomic Profiling as Standard of Care for Canadian Cancer Patients. Curr. Oncol. 2026, 33, 191. https://doi.org/10.3390/curroncol33040191
Snow S, Banerji S, Bombard Y, Husereau D, Karamchandani J, Nason E, Ohashi PS, van Rooijen G, Vainer G, Macaulay C, et al. Life Years Gained and Healthcare Dollars Saved: National Economic Evidence Supporting Comprehensive Genomic Profiling as Standard of Care for Canadian Cancer Patients. Current Oncology. 2026; 33(4):191. https://doi.org/10.3390/curroncol33040191
Chicago/Turabian StyleSnow, Stephanie, Shantanu Banerji, Yvonne Bombard, Don Husereau, Jason Karamchandani, Eddy Nason, Pamela S. Ohashi, Gijs van Rooijen, Gilad Vainer, Cassandra Macaulay, and et al. 2026. "Life Years Gained and Healthcare Dollars Saved: National Economic Evidence Supporting Comprehensive Genomic Profiling as Standard of Care for Canadian Cancer Patients" Current Oncology 33, no. 4: 191. https://doi.org/10.3390/curroncol33040191
APA StyleSnow, S., Banerji, S., Bombard, Y., Husereau, D., Karamchandani, J., Nason, E., Ohashi, P. S., van Rooijen, G., Vainer, G., Macaulay, C., & Servidio-Italiano, F. (2026). Life Years Gained and Healthcare Dollars Saved: National Economic Evidence Supporting Comprehensive Genomic Profiling as Standard of Care for Canadian Cancer Patients. Current Oncology, 33(4), 191. https://doi.org/10.3390/curroncol33040191

