Altarum staff developed a generalized health economic and outcomes research (HEOR) model to assess companion diagnostics, which are often used to target high-cost therapy. This analytical model was implemented in Microsoft Excel ™ and published in Expert Reviews in Pharmacoeconomics and Outcomes Research.

The model was applied to two case studies in this publication: KRAS mutation testing to target colorectal cancer therapy and HER2 testing to target breast cancer therapy. For this project, Altarum applied the model to compare alternative test strategies to identify candidates for crizotinib therapy, an oral oncology therapy for patients with advanced non-small cell lung cancer. Crizotinib therapy costs approximately $10,000 per month and initial clinical trials demonstrate substantial clinical benefit, yet only 4-6% of eligible patients are likely to benefit from the therapy. Thus, a highly accurate companion diagnostic strategy is essential.

Working with a pathologist and two oncologists, Altarum developed information regarding the costs and benefits of crizotinib therapy and the accuracy of alternative test strategies.  The analysis showed that more accurate CDx strategies, even though more costly, were of greater overall net benefit when accounting for patient outcomes, relative to lower cost, less accurate strategies.

The results of the analysis were published in Expert Reviews in Anti-cancer Therapy  [Expert Rev Anticancer Ther. 2013 May;13(5):625-36. doi: 10.1586/era.13.42. Testing for anaplastic lymphoma kinase rearrangement to target crizotinib therapy: oncology, pathology and health economic perspectives. Lee JA, Bubendorf L, Stahel R, Peters S. Source Altarum Institute, Ann Arbor, Michigan, USA. jim.lee@altarum.org.]