Cost-effectiveness of exome sequencing: an Italian pilot study on undiagnosed patients

Research output: Contribution to journalArticle

Abstract

Recent advances in genomic sequencing and their implementation in clinical practice are widely recognized as diagnostic milestones, and are influencing considerably medical decision making in term of patients’ management. The cost-effectiveness of genomic analysis as first-tier tests has been documented. However, only a few studies have assessed systematically the economic impact of a revised diagnostic trajectory based on exome sequencing in the health system for undiagnosed patients. We report on the assessment of diagnostic costs referred to a large cohort of patients enrolled in the Bambino Gesù Children’s Hospital’s “Undiagnosed Patients Program”, supporting the cost-effectiveness of exome sequencing in a universalistic health care service compared to the traditional multi-step diagnostic workup. Our data provide evidence that revision of health policy to promote genomic sequencing of patients with suspected Mendelian disorders would allow reallocation of resources for rare diseases from diagnostics to patient care. At a social level, diagnosis is crucial to receive the social “sick role” and establish an effective doctor-patient relationship. The application of genomic sequencing as first-tier diagnostic test does improve this process speeding up the diagnosis and management of undiagnosed patients.

Original languageEnglish
JournalNew Genetics and Society
DOIs
Publication statusPublished - Apr 9 2019

Fingerprint

Exome
Cost-Benefit Analysis
diagnostic
costs
Sick Role
health care services
economic impact
management
health policy
patient care
Rare Diseases
Health Policy
Routine Diagnostic Tests
Health Services
Patient Care
Disease
decision making
Economics
Delivery of Health Care
Costs and Cost Analysis

Keywords

  • cost-effectiveness
  • diagnosis
  • doctor-patient relationship
  • exome sequencing
  • health policy
  • rare diseases
  • undiagnosed patients

ASJC Scopus subject areas

  • Issues, ethics and legal aspects
  • Health(social science)
  • Genetics
  • Health Policy

Cite this

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abstract = "Recent advances in genomic sequencing and their implementation in clinical practice are widely recognized as diagnostic milestones, and are influencing considerably medical decision making in term of patients’ management. The cost-effectiveness of genomic analysis as first-tier tests has been documented. However, only a few studies have assessed systematically the economic impact of a revised diagnostic trajectory based on exome sequencing in the health system for undiagnosed patients. We report on the assessment of diagnostic costs referred to a large cohort of patients enrolled in the Bambino Ges{\`u} Children’s Hospital’s “Undiagnosed Patients Program”, supporting the cost-effectiveness of exome sequencing in a universalistic health care service compared to the traditional multi-step diagnostic workup. Our data provide evidence that revision of health policy to promote genomic sequencing of patients with suspected Mendelian disorders would allow reallocation of resources for rare diseases from diagnostics to patient care. At a social level, diagnosis is crucial to receive the social “sick role” and establish an effective doctor-patient relationship. The application of genomic sequencing as first-tier diagnostic test does improve this process speeding up the diagnosis and management of undiagnosed patients.",
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AU - Tartaglia, Marco

AU - Dallapiccola, Bruno

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