The Economic Impact of a Blood-Based Glycoproteomic Test for Early Detection of Colorectal Cancer

Introduction: Despite existing innovative screening methods, colorectal cancer (CRC) still poses a significant risk for cancer-related deaths. Recently, a new blood-based test assessing the host immune response to developing CRC through glycoproteomic profiling has emerged. Our study aimed to assess the potential health and economic impact of this non-invasive approach to CRC detection in a commercial payer population. Methods: We developed three budget impact models (BIMs) to simulate the utilization impact of a blood-based glycoproteomic test for detecting advanced adenomas (AA) and CRC. We modeled a one-year commercial payer population of 1 million (1M) covered lives and identified those at average or increased risk who were eligible for CRC screening (Figure 1). Cohorts were defined by risk categorization, with Cohort 1 including average risk patients, Cohort 2 including increased risk with personal history of findings, and Cohort 3 including increased risk with family history. Costs were assigned to these patient cohorts over a three-year period, including the costs of screening, cancer treatment, adverse events, and mortality. Results: The BIMs showed a net savings of $0.13 per member per month (PMPM) for the 1M patient population, including average and increased risk patients. On a per tested patient basis, adoption of the glycoproteomic test led to savings of $64, $501, and $547 for Cohorts 1, 2, and 3, respectively at a $500 test cost. Savings were driven primarily by a reduction in AAs that progressed to cancer (-11%), lower CRC treatment costs due to earlier stage disease detection (-3%), and reductions in mortality (-5%). Cancer incidence was reduced by 4%. Total colonoscopy procedures increased slightly (0.3%) due a net gain in the number of people screened, some of whom required a follow up colonoscopy. Across patient risk categorization, greater net payer savings were found among the increased risk cohorts ($0.06 PMPM) than the average risk cohort ($0.04) (Table 1). Conclusion: The addition of a novel glycoproteomic test to a CRC screening program could yield a net economic benefit for payers in addition to improved health outcomes. This economic benefit would be driven by a reduction in CRC treatment costs and a decrease in AA that progresses to cancer. By adopting this glycoproteomic testing approach, payers could improve patient outcomes while also reducing costs, making it a compelling strategy for enhancing CRC screening and prevention efforts.Figure 1.: Model Methodology Using Patient Risk Cohorts. Table 1. - Cohort Population Results Cohort #1 Cohort #2 Cohort #3 Net Savings per Glycoproteomic Tested Patient $64 $501 $547 Colonoscopy Testing ($4) ($146) ($146) Non-Invasive Testing ($346) ($500) ($500) CRC Staging (Non-AA to CRC Progression) $127 $129 $167 AA to CRC Progression $245 $938 $937 Mortality $41 $81 $89 PMPM Net Savings $.06 $.06 $.01 Per Eligible Due to be Screened Patient Colonoscopy Test Usage Change .1% .7% .4% Non-Invasive Test Usage Change 77.4% N/A N/A AA to CRC Reduction -14.7% -7.8% -7.8% AA HGD Reduction to CRC Progression -90% -90% -90% Mortality Rate Change -5.9% -4.6% -3.6% Average CRC Detection Stage Change -3.0% -1.4% -1.0% Per Glycoproteomic Tested Patient AA to CRC Reduction -75% -78% -78% Mortality Rate Change -31.4% -54.4% -51.6% Average CRC Detection Stage Change -16.2% -20.3% -20.3% Percentage of Patients Screened Timely (SOC/FUT) 32.6%/43.1% 38.5%/44.6% 57.9%/62.1%