Cost of Shield Blood Test for Colorectal Cancer Screening
The Guardant Shield blood test has a list price of $1,450 per test, recommended every 3 years for colorectal cancer screening. 1
Pricing Details
- List price: $1,450 per test 1, 2
- Testing interval: Every 3 years (as determined by CMS coverage decisions) 1
- Cost-effectiveness threshold: At the current list price, Shield appears prohibitively costly compared to alternatives like FIT or colonoscopy, though it remains cost-effective versus no screening at $74,800-$102,300 per quality-adjusted life-year gained 1
Cost-Effectiveness Context
At a hypothetical reduced price of $300 per test, Shield could become cost-saving versus no screening, though it would still be less effective and more costly than FIT or colonoscopy. 1
Recent modeling using real-world adherence data found Shield cost-effective at its current price with an incremental cost-effectiveness ratio of $48,662 per QALY gained (below the $100,000/QALY threshold), and remained cost-effective up to a unit cost of $3,241 at the $100,000/QALY threshold. 3
Important Clinical Caveats
- Shield is substantially less effective than established screening methods: It reduces CRC incidence by only 24-47% and CRC mortality by 53-59%, compared to FIT (45-77% and 67-81% respectively) or colonoscopy (57-81% and 72-88% respectively) 1
- The test has poor sensitivity for early detection: Only 13.2% sensitivity for advanced precancerous lesions and approximately 55% for stage 1 CRC 1
- Insurance coverage: CMS has approved coverage for Shield, though out-of-pocket costs may vary depending on individual insurance plans 1
Shield is best reserved for patients who refuse all other forms of colorectal cancer screening (FIT, Cologuard, or colonoscopy), as substituting it for more effective tests could result in worse population outcomes. 1