In late December 2019, news of a new flu-like virus began to emerge from the Hubei province in central China. But as the ball was dropping on New Year’s Eve, we had no idea that this virus would so rapidly reveal the fragility of the cancer testing ecosystem. Within 100 days, what we now know to be COVID-19 would have a far-reaching and global impact—delivering a system shock to all cancers.
To investigate the impact of the pandemic on cancer testing—and what the data reveal about challenges ahead for pharma and labs—Diaceutics devised the COVID-19 Oncology Tracker.1 We began by investigating the impact on China using the COVID-19 Oncology Tracker to generate insights on patient data, specifically lab claims data from commercial and public payers as well as real-time data from labs.1 Our research spanned 9 provinces in China to reveal that at the peak of the pandemic in February 2020, hospital visits overall decreased by approximately 40%—which impacted the number of cancer patients tested.2 The highly disruptive impact of COVID-19 was further evidenced by the decrease in cancer testing by as much as 50% from the previous quarter.2
To see if this disruption was occurring elsewhere, Diaceutics extended the analysis of cancer testing rates to the United States (US) to evaluate the short- and long-term impact on the cancer testing and treatment landscape. Initial findings from the Diaceutics COVID-19 Oncology Tracker indicated a 31% drop in newly diagnosed cases of lung cancer overall in the United States between February 2020 and March 2020.3
The impact on non‒small cell lung cancer (NSCLC) in particular in the US as captured by our COVID-19 Oncology Tracker is illustrated in the Figure below. This data set reveals that the number of patients newly diagnosed with NSCLC, or already diagnosed and poised for treatment, had both rapidly and significantly decreased—only 1 month following recommendations from groups such as the American Society of Clinical Oncology (ASCO) to delay "any clinic visits that can be postponed without risk to the patient,” adding that this could “potentially include patients who are suspected clinically of disease at low risk of rapid progression.”3-5 Such recommendations potentially will have profound consequences for patients starting their diagnostic journey or patients with late-stage disease awaiting access to a precision treatment that will ensue across 2020 to 2025.
Figure. Diaceutics’ COVID-19 Oncology Tracker: Impact of COVID-19 on United States non‒small cell lung cancer testing.1
The COVID-19 Oncology Tracker helps quantify the impact of the recommendations above, and subsequent shifting of healthcare resources, on oncology diagnosis and cancer testing rates—all of which have essentially set the stage for a cancer chain reaction in 2021.1 Access to such real-world, real-time data can help with decision-making regarding:
- 2021 forecasting,
- Salesforce optimization,
- Resource allocation and timing for deployment,
- Development of novel business models and solutions for reaching patients, and
- Scenario planning around required actions to rapidly restart diagnosis when situation resolves.
Analyzing the real-world global impact on biomarker testing in 2021 is imperative because of the chain reaction caused by COVID-19. Recommendations on transformational solutions will be needed to meet the testing demands ahead. As we turn our minds to the mid- to long-term impacts and learnings, and, subsequently, engineer a new normal for healthcare post–COVID-19, we would like to emphasize the importance of the following:
- In addition to exposing the fragile cancer testing ecosystem, COVID-19 has re-highlighted that the lab community is economically disadvantaged. This was already the case but now has been exacerbated by the national/global shock of COVID-19. This vulnerability needs to be addressed and future-proofed.
- COVID-19 has also put a spotlight on the siloed nature of the patient diagnostic pathway and the tendency of pharmaceutical companies, and the diagnostic companies they sponsor, to focus spending on one area of the diagnostic pathway only. This siloed approach leaves many steps within the pathway commercially orphaned (due to lack of economic incentive)—even though the objectives of multiple stakeholders are intertwined throughout the entire patient pathway. This approach, ultimately, compromises the patient journey by cultivating an imbalanced and vulnerable precision testing ecosystem. (Click here to download the Pharma Precision Medicine Readiness Report 2020: NSCLC—An Axis for Change to learn more about Diaceutics’ solution for the economic imbalance within the clinical diagnostic testing ecosystem.)
- Alongside the recurrence of global pandemics, it is highly likely that more novel diseases will emerge in our modern world every 2 to 3 years, as evidenced by SARS, COVID, and Zika in the past 25 years.6,7 Therefore, it is urgently crucial that oncologists, labs, diagnostic technology suppliers, regulators, and pharmaceutical companies integrate in order to act cohesively to protect patients and their diagnostic health experiences as they traverse their diseases. Cross industry integration is critical to get out in front.
Recovery from the impact of COVID-19 on the global oncology testing environment will require multiple stakeholder collaboration—just the kind possible on DXRX - The Diagnostic Network®. An end-to-end solution for the development and commercialization of PM diagnostics, DXRX - The Diagnostic Network® harnesses the power of the world’s largest repository of real-world testing data form 2500+ labs in 51 countries and enables a vibrant marketplace where labs, and pharmaceutical and diagnostic companies come together to find trusted partners and collaborations in a secure, standardized way. For more information on DXRX - The Diagnostic Network®, please visit dxrx.diaceutics.com.
- COVID19 Oncology impact tracker. Diaceutics Web site. https://www.diaceutics.com/covid19-oncology-impact-tracker/. Accessed November 17, 2020.
- Diaceutics Data on File: Diaceutics’ proprietary Global Diagnostic Index (GDI) unpublished data, 2020.
- Cancer testing and diagnosis suffers sharp downturn, finds Diaceutics. Businesswire Web site.
https://www.businesswire.com/news/home/20200429005104/en/Cancer-Testing-DiagnosisSuffers-Sharp-Downturn-finds. Published April 29, 2020. Accessed November 17, 2020.
- Ray T. Amid COVID-19, lower cancer diagnosis rates mean fewer patients getting molecular tests, treatment. Genomeweb Web site. https://www.precisiononcologynews.com/molecular-diagnostics/amid-covid-19-lower-cancer-diagnosis-rates-mean-fewer-patients-getting. Published April 27, 2020. Accessed November 17, 2020.
- Cancer screening, diagnosis, staging & surveillance. ASCO Web site. Updated June 22, 2020. https://www.asco.org/asco-coronavirus-resources/care-individuals-cancer-during-covid-19/cancer-screening-diagnosis-staging. Accessed November 18, 2020.
- Dalton J. Coronavirus: timeline of pandemics and other viruses that humans caught by interacting with animals. Independent Web site. https://www.independent.co.uk/news/uk/home-news/coronavirus-pandemic-viruses-animalsbird-swine-flu-sars-mers-ebola-zika-a9483211.html. Published April 24, 2020. Accessed November 17, 2020.
- Whiting K. Coronavirus isn't an outlier, it's part of our interconnected viral age. World Economic Forum Web site. https://www.weforum.org/agenda/2020/03/coronavirus-global-epidemics-health-pandemic-covid-19/. Published March 4, 2020. Accessed November 17, 2020.