Patient preferences and National Health Service costs: a cost-consequences analysis of cancer genetic services

Abstract

The study has three aims; firstly to establish if, having been informed of their risk status and that gene testing is inappropriate for them, low and moderate risk patients have misunderstood or failed to grasp this and want a test that is inappropriate for them. Secondly, to elicit patients' willingness to pay for cancer genetic services. Thirdly, to ascertain the aspects of cancer genetics services that are important to high risk patients and present service configurations prioritised in terms of preferences accompanied by their costs (cost-consequences analysis). Patient preferences were gathered from 120 patients returning a self-administered discrete choice questionnaire issued post genetic risk assessment. Patients at low and moderate risk of developing breast cancer desired inappropriate testing. Patients at high, moderate and low risk of developing genetic cancer were willing to pay up to 3,000 pounds for genetic serviced, which exceeds the current estimated cost of providing testing and counselling. Counselling by a genetics associate accompanied by favourable levels of other attributes provided high utility and substantial cost savings.

Impact of subsidies on cancer genetic testing uptake in Singapore

“…Of patients who chose to do genetic testing, 52% were ineligible for subsidy and willingly paid the cost of testing entirely out-of-pocket. In the UK, patients were willing to pay up to £3000 (S$5565) for genetic services 27. This is consistent with prior research that revealed individuals of higher socioeconomic status who seek cancer risk assessment have strong intentions to undergo genetic testing, and that intention is associated with perceived risk of developing cancer, benefits of preventive screening and control over cancer risks 28.…”

Value of Genetic Testing for Hereditary Colorectal Cancer in a Probability-Based US Online Sample

“…40 In contrast to samples of adults from the general population in the US and in Canada, patients at low, medium, and high risk for breast cancer in Great Britain would pay up to 3,000 pounds sterling (approximately $4,850) for genetic testing, a value above the cost of testing to the National Health Plan. 41 …”

Willingness to Pay for Genetic Testing: A Study of Attitudes in a Canadian Population

“…Patients at all risk levels indicated willingness to pay up to GBP 3,000, an amount that exceeds the actual cost of providing such services through the publicly funded National Health Service [15]. A previous study of ovarian cancer patients found that 74% said they would pay 20% of the cost of genetic testing that would aid their therapy and only a quarter of respondents would pay the full cost [16].…”