Towards a single-assay approach: a combined DNA/RNA sequencing panel eliminates diagnostic redundancy and detects clinically-relevant fusions in neuropathology

Table 4 Cost of typical diagnostic work-up for infiltrating glioma cases including IHC for GFAP, IDH1-R132H, p53, ATRX, and Ki-67; FISH (for 1p/19q assessment, EGFR assessment, and CDK2NA assessment); and cost of running and interpretation of the Oncomine targeted NGS panel, as compared to the Oncomine panel-only, as well as IHC and FISH studies only

Diagnostic test	Tech time and reagents	Professional component–medicare reimbursement	Total cost
IHC (5 IHC)	$26 × 5 = $130	(IHC code 342 × 1 at $34) + (IHC code 341 × 3 at $28) + (IHC code 360 × 1 at $41) = $159	$289
FISH (1p/1q, 19p/19q, EGFR/centromeric, CDKN2A/centromeric)	$127 × 4 = $508	FISH code 377 × 4 at $63 = $252	$760
NGS (Oncomine v2)	$700	$48	$748

Total cost of diagnostic work-up			Total cost
Standard (IHC, FISH, and NGS)	$1338	$459	$1797
NGS alone	$700	$48	$748
IHC and FISH	$638	$411	$1049

The costs listed reflect an estimate of technician time and reagents, plus the Medicare reimbursement rate of the professional component as a proxy for a standardized interpretation portion of the cost. We recognize that these values can vary widely across institutions. NGS costs are calculated on a per-case cost with the assumption that full batches are run

ISSN: 2051-5960