Economic analysis of combined multi-cancer detection blood test and usual care.

e23055 Background: A previous multi-cancer detection blood test (MCDBT) in six prevalent and deadly cancers including colorectal, esophageal, liver, lung, ovarian, and pancreatic cancers, has been reported to decrease late-stage incidence and increase 5-year survival rate. However, the economic cost-effectiveness of integrating the MCDBT with usual care and the factors influencing it have not been investigated. Methods: An interception model was utilized to estimate the stage distribution at the time of cancer diagnosis, while a decision-tree model was developed to assess the clinical and economic outcomes of annual MCDBT for individuals aged 50 to 79 in the United States. The performance metrics for the MCDBT were based on the findings of a previous study called THUNDER. The incidence data were derived from the Surveillance, Epidemiology, and End Results Program (SEER), and the associated costs were obtained from SEER-Medicare. Other input data was estimated based on information available in the published literature. Results: In addition to the usual care, the integration of the MCDBT resulted in a shift of 27. 9% in cancer cases from stage III-IV to stage I-II, which led to a decrease in per-cancer treatment cost by 5971 and an increase in quality-adjusted life-years by 0. 10 per cancer case. The major factors that influenced the incremental cost-effectiveness ratio (ICER) included price, incidence, specificity, and sensitivity. The MCDBT with a price less than 800 showed cost-effectiveness with an ICER below three times the per capita GDP of the United States in the average-risk population. In a high-risk population with the incidence two-fold higher than the average-risk population, the ICER decreased by 58. 3%. When compared the influence of specificity and sensitivity on the ICER of the MCDBT, a 5% increase in specificity resulted a decrease in ICER by 48. 8%, while a 5% increase in sensitivity only reduced the ICER by 12. 7%, suggesting the importance of high specificity in MCDBT. Conclusions: The MCDBT with a price less than 800 showed cost-effectiveness in the detection of colorectal, esophageal, liver, lung, ovarian, and pancreatic cancers. Price, incidence of the intended-use population, specificity and sensitivity were the major factors that influenced the cost-effectiveness.