HOPE Center Compares Cost-Effectiveness of PD-L1 Testing in Non-Small Cell Lung Cancer

College of Pharmacy and HOPE Center investigators, JASON HURWITZ, MS, PHD, SHANNON VAFFIS, MPH, PMP, and AMY GRIZZLE, PHARMD, co-authored a new study in Oncology and Therapy titled Cost-Effectiveness of PD-L1 Testing in Non-Small Cell Lung Cancer (NSCLC) Using In Vitro Diagnostic (IVD) Versus Laboratory-Developed Test (LDT).

In many countries, allocating treatment for non-small cell lung cancer (NSCLC) with either pembrolizumab or chemotherapy relies on PD-L1 testing using either in vitro diagnostic (IVD) or a laboratory-developed test (LDT). The researchers developed a decision model to compare the cost-effectiveness of PD-L1 testing using IVD compared to LDT from the German healthcare perspective. Accurate testing is essential to personalize therapy and maximize the benefit of immune checkpoint inhibitor (ICI) drugs such as pembrolizumab, since eligible patients have been shown to have improved survival and side effect profiles compared to chemotherapy.

This study found PD-L1 testing accuracy was 93% in the IVD group compared to 73% in the LDT group, with most misclassifications being false negatives (7% of IVDs and 21% of LDTs). Total per patient costs of the IVD group (48,878 €) were 196 € higher than the LDT group (48,682 €), with total effectiveness 19 percentage points higher for IVD (88%) compared to LDT (69%).

The authors concluded that accurate PD-L1 testing with IVD is only slightly more expensive than LDT, ensures optimal treatment for those eligible for drugs like pembrolizumab, improves survival, and limits adverse event exposure.

The HOPE team worked with international colleagues representing quality assurance organizations from the UK and Denmark. Principle investigator, Jason Hurwitz shared “It was exciting to work with real-world data on the accuracy of these diagnostic tests from our quality assurance partners. Amy and I also appreciated the opportunity to collaborate with our graduate student, Shannon Vaffis, who is preparing to graduate with her PhD.”