Cost analysis of noninvasive blood-based microRNA testing versus CT scans for follow-up in patients with testicular germ-cell tumors

Daniel Charytonowicz, Harry Aubrey, Chantelle Bell, Maeline Ferret, Keith Tsui, Rachel Atfield, Nicholas Coleman, Matthew J. Murray, Edward C. F. Wilson

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)
11 Downloads (Pure)


BACKGROUND: Our group has developed a noninvasive blood-based microRNA (miRNA) test for improving diagnosis, disease monitoring, and relapse detection in malignant testicular germ-cell tumors (TGCTs). Performance analysis suggests the test is likely to have comparable sensitivity and specificity in detecting TGCT as computed tomography (CT), thus reducing the need for serial CT scans for follow-up monitoring, with associated reductions in cumulative radiation burden and second cancer risk. To facilitate clinical adoption, we undertook a cost analysis to identify the budget impact of replacing CT scans with miRNA testing within health care systems.

METHODS: The TGCT aftercare pathway was mapped out using National Comprehensive Cancer Network guidelines. A Markov model was built to simulate the impact of the miRNA test on TGCT aftercare costs. Incidence, treatment probabilities, relapse rate, and death rate data were collected from published studies to populate the model.

RESULTS: Applying our model to the US health care system, the miRNA test has the potential to save up to $69 million per year in aftercare expenses related to TGCT treatment, with exact savings depending on the adoption rate and test price.

CONCLUSION: This analysis demonstrates the potential positive budget impact of adopting miRNA testing in place of CT scans in the clinical management of TGCTs.

Original languageEnglish
Pages (from-to)e733-e744
Number of pages12
JournalClinical Genitourinary Cancer
Issue number4
Early online date26 Mar 2019
Publication statusPublished - Aug 2019
Externally publishedYes


  • Biomarkers, Tumor/genetics
  • Costs and Cost Analysis
  • Follow-Up Studies
  • Genetic Testing/economics
  • Humans
  • Male
  • Markov Chains
  • MicroRNAs/genetics
  • Neoplasm Staging
  • Neoplasms, Germ Cell and Embryonal/diagnosis
  • Prognosis
  • Survival Analysis
  • Testicular Neoplasms/diagnosis
  • Tomography, X-Ray Computed/economics

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