Reimbursement Landscape for NGS in Oncology in Australia, Canada, and the United States

Reimbursement Landscape for NGS in Oncology in Australia, Canada and the United States

Next-generation sequencing (NGS) encompasses technologies that enable rapid, high-throughput genetic sequencing, offering faster and less expensive alternatives to conventional Sanger sequencing by identifying multiple allelic variants simultaneously. NGS achieves this by fragmenting DNA and sequencing each fragment concurrently. The reduced cost and speed of NGS has numerous health care applications, such as newborn screening for genetic diseases and diagnosing genetic conditions to expedite treatment.

In oncology, NGS is used to test for germ-line mutations and assess cancerous tissue for genetic mutations, aiding in treatment decisions. As of 2017, many oncologists in the United States rely on NGS for treatment planning, and the technology supports the use of targeted, often expensive, therapies by identifying suitable patients, thereby optimizing health care spending. This paper examines how NGS tests can gain reimbursement and wider use, given their potential to guide treatment decisions and make targeted therapies more economically viable.