title: The importance of test accuracy in economic evaluations of companion diagnostics.
abstract: BACKGROUND
  Economic evaluations of companion diagnostics often fail to include the impact that tests have on the overall economic value of test-drug combinations.
  
  
  METHODS
  To illustrate the importance of test accuracy on the cost-effectiveness of companion diagnostics by means of examples. Data were extracted from the literature.
  
  
  RESULTS
  The accuracy of a test and in particularly its specificity, is often more influential on the overall cost-effectiveness results than the price of the test. Specificity becomes more crucial when prevalence of the biomarker is low. Multiple, simultaneous testing faces specific challenges regarding its overall specificity.
  
  
  CONCLUSIONS
  This article opens a discussion on some fundamental points linked to economic evaluations of test-therapy combinations.
authors.affiliation: KCE Belgian Health Care Knowledge Centre, Doorbuilding (9th Floor), Boulevard du Jardin Botanique 55, 1000 Brussels, Belgium.
authors.forename: Lorena
authors.initials: L
authors.lastname: San Miguel
authors.affiliation: KCE Belgian Health Care Knowledge Centre, Doorbuilding (9th Floor), Boulevard du Jardin Botanique 55, 1000 Brussels, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Hulstaert
mesh_terms: D015415:Biomarkers; D003362:Cost-Benefit Analysis; D005060:Europe; D006801:Humans; D057285:Precision Medicine / Q000191:economics*; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers
keywords: companion diagnostics; cost–effectiveness; economic evaluation; next-generation sequencing; test accuracy