Genetic testing poised for growth, but costs remain a concern

Credit: Office of Biological and Environmental Research of the U.S. Department of Energy Office of Science

A report issued March 12 by the UnitedHealth Group’s Center for Health Reform & Modernization finds that physicians look favorably upon the use of genetic testing to help diagnose disease and target prevention and ensure that patients receive the medicines that will best treat their conditions.

According to the report, titled “Personalized medicine: Trends and prospects for the new science of genetic testing and molecular diagnostics,” genetic testing is currently available for about 2,500 conditions, including cancers and communicable diseases. Full genome sequencing, which maps an individual’s entire genetic code, is also expected to become widely available, possibly as soon as this year.

“Genetic science offers unprecedented potential to prevent disease and improve diagnosis and treatment, ushering in an era of truly personalized care,” said Simon Stevens, executive vice president of the UnitedHealth Group and chairman of the UnitedHealth Center for Health Reform & Modernization. “But for patients to realize these practical benefits, we will also need new models of research and care delivery combined with informed choice and appropriate consumer safeguards.”

The report includes new survey results on patient and physician views on genetic testing. Most American consumers are optimistic about the potential benefits from advances in genetic testing, according to a national survey of U.S. adults conducted by UnitedHealth Group/Harris Interactive, included in the report. About three-quarters of survey respondents agree that genetic tests help doctors diagnose preventable conditions and offer more personalized treatment options. Most consumers expect that five years from now the use of testing will have increased. However, the coding system used across the country to monitor medical tests offers few codes to describe genetic tests for specific diseases.

The survey also finds that a majority of U.S. doctors say that genetic testing will improve care across a range of health problems in the future, allowing for more personalized medical decisions and more targeted choice of therapy. On average, physicians report having recommended genetic testing for 4 percent of their patients over the past year. Looking ahead five years, physicians on average feel that 14 percent of their patients will have had a genetic test; however, nearly three of every five doctors say they are very concerned about the cost of genetic tests.

“The mapping of the human genome and use of genetic testing in diagnosing and treating diseases are landmark breakthroughs in modern medicine,” said Reed Tuckson, MD, chief of medical affairs at the UnitedHealth Group and former chairman of the Health & Human Services Secretary’s Advisory Committee on Genetics, Health and Society. “It is now up to all of us to foster an environment that encourages innovation in these tests and related treatments, as well as their responsible use, so as to bring about real-world improvements in care.”

The report also contains analyses of the experience of individuals covered by UnitedHealthcare; the results show the cost of genetic and molecular diagnostic testing for UnitedHealthcare health plan participants in 2010 was approximately $500 million.

Per-person spending on genetic testing for UnitedHealthcare’s Medicare and Medicaid members was higher than for UnitedHealthcare’s employer-sponsored and individually insured population by 16 percent and 24 percent, respectively.

Extrapolating from these data, the report suggests that national spending on these services in 2010 may have reached around $5 billion. Looking forward, the report projects that spending on genetic testing may reach between $15 billion and $25 billion annually in the United States by 2021.