A very significant and detrimental imbalance exists within the Precision Medicine (PM) clinical diagnostic testing ecosystem today that allows patient leakage to persist, denying many patients potentially life-saving treatments. This imbalance derives from the stark differences between the revenues and rewards extracted by the pharmaceutical versus diagnostic industries in terms of treatment versus testing.
The non‒small cell lung cancer (NSCLC) landscape is particularly beset with this economic inequity. Within NSCLC, the PM treatment market functions well enough to provide innovators with adequate return on investment (ROI), safeguarded by intellectual property (IP) protection for treatment, and steep investment barriers to entry provide key players adequate market protection to invest in capabilities required to educate physicians about new treatment and testing options. The precision testing market, however, historically has lacked the economic momentum of value-based reimbursement, IP protection, and dominant diagnostic powerhouses to drive the investment and change essential to eliminating suboptimal areas of the broken clinical diagnostic testing ecosystem. Consequently, the precision testing market extracts only 3% of the financial value compared with the financial value pharma companies extract from NSCLC, according to a Diaceutics’ analysis—yet the test alone delivers 29% to 57% of the health economic value captured in the therapy price.1
Diaceutics exposes this economic imbalance in the latest Pharma PM Readiness Report 2020: NSCLC—An Axis for Change (downloadable here) in order to call out the following:
Economic imbalance itself holds back the better use of diagnostic testing in the management of cancer. Unfortunately, not many incentives exist on the diagnostic side alone to fix this. Ergo someone else has to fix it, and we typically look to those with the deeper pockets to do so, such as the pharma industry.
Greater participation in the diagnostic journey holds the potential for greater value in terms of higher ROI for pharmaceutical industry, higher pricing for the pharmaceutical industry accepted as justified by payers, and, most importantly, earlier diagnosis of patients. So, there is a lot of value to be driven from getting more involved in in the “poorer side” of the equation.
DXRX - The Diagnostic Network® enables a vibrant marketplace to drive higher value through collaboration, which enables solutions to access and diagnostic issues. The world’s first diagnostic network for PM, DXRX is an end-to-end solution for the development and commercialization of PM diagnostics, from biomarker discovery to in-market test availability. All stakeholders in Precision Medicine come to DXRX to find trusted partners for collaboration on PM diagnostics in a secure, standardized way. Ultimately, such collaboration will allow for a redistribution of investment flowing from those who are garnering a significant amount of revenue back to the areas along the diagnostic pathway that are being traditionally starved of investment (e.g., education on biomarkers, support to bring on new biomarkers quickly, programs to enable more effective lab-physician communication). DXRX provides the various tools and capabilities to enable that redistribution. The DXRX Marketplace is an environment in which such redistribution can organically occur, much like the organic change in balance seen via other marketplace platforms, such as Uber and Airbnb.
Currently, the diagnostic marketplace is “crying out” for higher investment. Typically, investment in a new companion diagnostic (CDx) ranges between $3 million to $12 million, which includes the development of a new Kit. That investment needs to be much higher, as in $40 million to $50 million per biomarker to ensure ample support. DXRX provides the ability for people to come together to collaborate and seek a redistribution—not one wildly throwing money around but one directing investment very specifically towards what needs to be fixed—through intent consideration of how we can achieve this, who can invest, and what ROI can be expected. This is how the DXRX Marketplace will start to create that balance change. In time we will see how DXRX - The Diagnostic Network® enabled that so needed change.
(Click here to download the Pharma PM Readiness Report 2020: NSCLC—An Axis for Change.)
Henderson R, Lawler M, Keeling P, et al. PCN60 Cost-effectiveness of precision diagnostic testing and Precision Medicine for non-small cell lung cancer: a systematic review. Value Health. 2020;23:S33. https://doi.org/10.1016/j.jval.2020.04.1563. Accessed October 16, 2020.