Study: Exact's Cologuard ranks low for cost effectiveness among CRC screening tests

A study published in Plos One found Exact Sciences' Cologuard was less effective and more costly than other CMS-reimbursed screening strategies.

Researchers developed three independent microsimulation models to screen a simulated group of 65-year-old Americans through one of six CMS-reimbursed screening methods, including Cologuard, a multitarget stool DNA test. Researchers projected the models to adhere to 100 percent screening adherence, which they acknowledged was not reflective of real life adherence. 

Researchers found all methods reduced CRC incidence and mortality. In an unscreened population, Cologuard added 82 life years per every 1,000 simulated screening. In that same population, Cologuard was more effective than five-year sigmoidoscopy — which added 80 life years, but was less effective than every other simulated strategy.

Only two strategies were cost efficient in all models: 10-year colonoscopy and an annual fecal occult blood test. Cologuard was the most expensive option when compared to every screening strategy. Researchers found Cologuard was only more cost effective than doing nothing at all. Researchers noted Cologuard was an efficient and potentially cost-effective screening option when reimbursement rates were reduced to around $6 to $18 dollars per test. However, one model found that the test would never be cost effective.

For Cologuard to be a cost-effective option at its base-case reimbursement rate of $512, adherence rates would have to be between 31 percent and 53 percent better. Researchers also noted that at its current reimbursement, Cologuard could be an effective option for patients who would not submit to other tests.

Researchers concluded: "Compared to no screening, triennial mtSDNA screening reduces CRC incidence and mortality at acceptable costs. However, compared to nearly all other CRC screening strategies reimbursed by CMS it is less effective and considerably more costly, making it an inefficient screening option."

Read the entire study here.

Note: After the study was published, Exact Sciences released a press release touting the test's ability to help patients get screened in a cost-effective way. We also reached out to Exact for comment and will update when we hear back.


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