title: The cost of molecular-guided therapy in oncology: a prospective cost study alongside the MOSCATO trial.
abstract: There is increasing use of molecular technologies to guide cancer treatments, but few cost data are available. Our objective was to assess the costs of molecular-guided therapy for patients with advanced solid tumors alongside the Molecular Screening for Cancer Treatment and Optimization (MOSCATO) trial.
  
  
  
  The study population consisted of 529 patients. The molecular diagnosis included seven steps from tumor biopsy to the multidisciplinary molecular tumor board. The cost of a complete molecular diagnosis was assessed by micro-costing. Direct costs incurred from enrollment until progression were assessed from the French National Health Insurance perspective.
  
  
  
  The patients' mean age was 54 years (range: 3-82) and the mean follow-up period was 145 days (range: 1-707 days). A complete molecular diagnosis cost [euro ]2,396. There were 220 patients with an actionable target (42%), among whom 105 (20%) actually received a targeted therapy. The cost of molecular-guided therapy per patient was [euro ]31,269. The main cost drivers were anticancer drugs (54%) and hospitalizations (35%).
  
  
  
  This prospective cost analysis showed that molecular diagnosis accounts for only 6% of the cost of molecular-guided therapy per patient. The costs of drugs and hospitalizations are the main cost drivers.Genet Med advance online publication 01 December 2016.
authors.affiliation: Gustave Roussy, Service de Biostatistique et d'Epidémiologie, Villejuif, France.
authors.forename: Arnaud
authors.identifier: 0000-0002-2337-8693
authors.initials: A
authors.lastname: Pagès
authors.affiliation: Gustave Roussy, Service de Biostatistique et d'Epidémiologie, Villejuif, France.|CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Paris-Sud Univ., Villejuif, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Foulon
authors.affiliation: Gustave Roussy, Service de Biostatistique et d'Epidémiologie, Villejuif, France.|CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Paris-Sud Univ., Villejuif, France.
authors.forename: Zhaomin
authors.initials: Z
authors.lastname: Zou
authors.affiliation: Gustave Roussy, Département de Biologie et Pathologie Médicales, Villejuif, France.|Université Paris-Sud, Paris-Saclay, Orsay, France.|Gustave Roussy, Laboratoire de Recherche Translationnelle et Centre de Ressources Biologiques, AMMICA, INSERM US23/CNRS UMS3655, Villejuif, France.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Lacroix
authors.affiliation: Gustave Roussy, Département de la Pharmacie Clinique, Villejuif, France.|Université Sorbonne-Paris cité, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France.
authors.forename: François
authors.identifier: 0000-0001-8196-970X
authors.initials: F
authors.lastname: Lemare
authors.affiliation: Université Paris-Sud, Paris-Saclay, Orsay, France.|Gustave Roussy, Département de Radiologie Interventionnelle, Villejuif, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: de Baère
authors.affiliation: Gustave Roussy, Département d'Innovation Thérapeutique et Essais Précoces, Villejuif, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Massard
authors.affiliation: Université Paris-Sud, Paris-Saclay, Orsay, France.|Gustave Roussy, Département d'Innovation Thérapeutique et Essais Précoces, Villejuif, France.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Soria
authors.affiliation: Gustave Roussy, Service de Biostatistique et d'Epidémiologie, Villejuif, France.|CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Paris-Sud Univ., Villejuif, France.
authors.forename: Julia
authors.initials: J
authors.lastname: Bonastre
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000191:economics; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000191:economics*; D009369:Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000235:genetics; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents