Abstract 292P
Background
A national targeted lung screening programme was introduced in the United Kingdom (UK) in 2023. Alongside with the increased use of chest imaging in routine practice, an increased finding of lung nodules is to be expected. Adding liquid biopsy (LB) to the diagnostic pathway can potentially reduce invasive investigations and lead to faster diagnosis. The objectives were to investigate the cost-effectiveness of using LB in lung cancer diagnosis through systematic review, and to investigate its financial consequences to the UK National Health Service (NHS) by performing a budget impact analysis with hypothetical models.
Methods
A systematic literature search was conducted on different databases and screened against the pre-determined eligibility criteria. Qualitative analysis was used to combine all the findings of the eligible studies. Three budget impact models and two hypothetical LB diagnostic pathways were built for the budget impact analysis, using the data from the systematic review studies.
Results
Three eligible studies demonstrated that integrating LB into the lung cancer diagnostic pathway is cost-effective. The budget impact models showed that using LB with high positive predictive value (PPV) but low negative predictive value (NPV) costs more than the current diagnostic pathway, but it could lead to quicker diagnosis and treatment. Using liquid biopsy with high NPV but low PPV could lead to cost-saving. Summary of the costs of each scenario and their budget impact compared to the current diagnostic pathway (CDP).
Table 292P| Costs over 3 years | Budget Impact Compared to CDP | |
| CDP without LB | £1,169,324,669 | |
| LungLB liquid biopsy by Schneider et al. (high PPV, low NPV) Hypothetical biomarker by | £3,497,666,271 £1,404,912,319 | £2,328,341,602 £235,587,650 |
| Toumazis et al (high PPV, low NPV) | ||
| Micro-RNA signature classifier by Zhao et al. (high NPV, low PPV) | £786,650,900 | −£382,673,769 |
Conclusions
Using LB in the lung cancer diagnostic pathway is cost-effective. These novel LB diagnostic pathways could lead to either earlier diagnosis or cost-saving to the UK NHS. Our budget impact models could be helpful to other healthcare systems as they can input their own population and costs data into the models. It could also be used in the early economic assessments of other precision cancer medicine approaches.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.