Table 1 List with factors, alongside clinical benefit and costs, that might be relevant in reimbursement decision-making for comprehensive genomic profiling. WGS whole genome sequencing

1. Feasibility

To what extend are the available infrastructure and human resources suitable to perform the diagnostic tests in terms of:

 • Data storage

 • Interpretation of test results

 • Method of biopsy preparation (in case of WGS; fresh frozen tissue)

2. Patient and physician test journey

The diagnostic experience from the patient and oncologist perspective:

 • Time interval from requesting the test to results

 • Number of procedures to obtain biopsies (including germline for WGS)

 • Success rate of the test strategy

 • Completeness of results (are all results available at once)

 • Complexity test request for oncologist

3. Wider implications of diagnostic results

Possibility of using the test results for the selection of additional treatment options:

 • Off-label treatments

 • Tumor-agnostic treatments

 • Phase I, II, III studies

Or for the identification of:

 • Predictors for a negative treatment response

 • Hereditary cancer predisposition genes

 • Pathogenic viruses

 • Pharmacogenetic profiles

 • A revision of the diagnosis

4. Organization of labs

The impact of the diagnostic test on the organization of labs regarding the:

 • Uniformity of tests (variation between available tests)

 • Future-proofness (is the test able to test for biomarkers that will be relevant in the future)

 • Equity (are there differences in the availability of tests)

5. Scientific spillover

Potential of using the test results to:

 • Develop a learning care system by generating data

 • Identify new (complex) biomarkers