{"id":936,"date":"2012-03-15T13:17:24","date_gmt":"2012-03-15T17:17:24","guid":{"rendered":"http:\/\/blogs.cdc.gov\/genomics\/?p=936"},"modified":"2024-04-08T14:19:59","modified_gmt":"2024-04-08T18:19:59","slug":"the-public-health-approach-to-genetic-testing","status":"publish","type":"post","link":"https:\/\/blogs.cdc.gov\/genomics\/2012\/03\/15\/the-public-health-approach-to-genetic-testing\/","title":{"rendered":"The Public Health Approach to Genetic Testing in the 21st Century: Saving Lives and Saving Unnecessary Healthcare Costs"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.cdc.gov\/genomics\/files\/2012\/03\/BloodVialsCash.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-image-977\" src=\"https:\/\/blogs.cdc.gov\/genomics\/files\/2012\/03\/BloodVialsCash-300x200.jpg\" alt=\"vials on top of money\" width=\"300\" height=\"200\" srcset=\"https:\/\/blogs.cdc.gov\/genomics\/wp-content\/uploads\/sites\/20\/2012\/03\/BloodVialsCash-300x200.jpg 300w, https:\/\/blogs.cdc.gov\/genomics\/wp-content\/uploads\/sites\/20\/2012\/03\/BloodVialsCash-1024x682.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>In March 2012,\u00a0a prominent\u00a0health insurer in the United States released a white paper entitled: \u201c<a href=\"https:\/\/www.unitedhealthgroup.com\/newsroom\/2012\/0312whitepaper7personalizedmedicine.html\" target=\"_blank\" rel=\"noopener noreferrer\">Personalized Medicine: trends and prospects for the new science of genetic testing and molecular diagnostics<\/a>\u201d By analyzing their own claims data, the report suggests that in 2010, the cost of genetic and molecular diagnostic testing for its members was about $500 million; nearly 40 percent was for molecular testing for infectious diseases, 16 percent for cancer, and the rest for a variety of conditions including inherited disorders. \u00a0The report estimates that spending on molecular and genetic tests increased by about 14 percent a year between 2008 and 2010, reaching an estimated $5 billion in 2010. Based on different growth scenarios, the report estimates that U.S. spending for genetic testing could reach between $15 billion and $25 billion by 2021. While three-quarters of doctors surveyed in the report believe that genetic testing allows for more personalized therapy, 56 percent think that new genetic tests will <em>increase<\/em> health care costs, compared with 19 percent who think genetic testing will reduce health care costs. &#8220;<a href=\"http:\/\/www.latimes.com\/business\/la-fi-genetic-test-20120312,0,2192512.story\" target=\"_blank\" rel=\"noopener noreferrer\">We are now in the era of truly personalized care,&#8221; said Reed Tuckson, chief of medical affairs at UnitedHealth Group.<\/a> &#8220;However, this also poses significant challenges to a system that is increasingly unaffordable.&#8221;\u00a0\u00a0<!--more--><\/p>\n<p>The findings in this report have enormous public health implications. Undoubtedly, genomic and molecular technologies will eventually provide useful tools for the diagnosis and management of various diseases, screening and early detection, as well as risk assessment, health promotion and prevention. If anything, scientists have predicted that genetic testing can lead to <a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1114866\" target=\"_blank\" rel=\"noopener noreferrer\">more personalized or precision medicine<\/a>\u00a0that could <em>save <\/em>healthcare costs by <a href=\"http:\/\/www.latimes.com\/business\/la-fi-genetic-test-20120312,0,2192512.story\" target=\"_blank\" rel=\"noopener noreferrer\">delivering the right intervention to the right person at the right time<\/a>.<\/p>\n<p>How can we ensure that genetic testing saves lives <em>and<\/em> saves unnecessary healthcare costs at the same time? As we recently outlined in the <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22095352\" target=\"_blank\" rel=\"noopener noreferrer\">American Journal of Public Health<\/a>, fulfilling the promise of genomics in improving health requires a public health perspective. Population research is urgently needed to 1) assess the contribution of genomics and other new markers to health and disease in the larger social and environmental context (2) evaluate promising genomic technologies for their potential to improve health and healthcare; (3) design appropriate strategies for integrating genomics into clinical and public health practice and ensuring access; and (4) continuously measure population health impact of these new technologies. We know all too well that life-saving interventions can be \u201c<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21189494\" target=\"_blank\" rel=\"noopener noreferrer\">lost in translation<\/a>\u201d and do not always reach all people who need them. On the other hand, \u201c<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21189494\" target=\"_blank\" rel=\"noopener noreferrer\">premature translation<\/a>\u201d\u00a0of unvalidated technologies may fail to improve health outcomes, while increasing unnecessary healthcare costs.<\/p>\n<p>These actions are consistent with the essential mission of the \u201cpublic health system\u201d in the US, namely to ensure conditions by which people can be healthy. This involves collaboration between private and public sectors of society. Three essential public health functions can be applied to genomic medicine: <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21311338\" target=\"_blank\" rel=\"noopener noreferrer\">policy development, assurance and assessment<\/a>.<\/p>\n<ol>\n<li><strong>Policy development: <\/strong>\u00a0public health serves as a convener and honest broker, advising providers, the public, and policy makers on the potential net health impact of a particular health technology including genetic testing.<\/li>\n<li><strong>Assurance <\/strong>involves implementing appropriate programs (such as newborn screening), laws, and regulations, assuring access, and strengthening providers\u2019 genomic competencies and the general public\u2019s health literacy.<\/li>\n<li><strong>Assessment<\/strong> applies public health sciences to monitor and evaluate effectiveness, quality and outcomes of deployment of genomic technologies in populations.<\/li>\n<\/ol>\n<p>In summary, a public health approach to genomic medicine is essential if the new technology is to be used in a way that saves lives <em>and <\/em>saves healthcare costs at the same time. We agree with the conclusion of the report: \u201cIn short, we can do more to realize the full potential of these new scientific discoveries, and improve the health of the population. It is time to do so.\u201d<\/p>\n<p>We appreciate input from our readers on this post.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In March 2012,\u00a0a prominent\u00a0health insurer in the United States released a white paper entitled: \u201cPersonalized Medicine: trends and prospects for the new science of genetic testing and molecular diagnostics\u201d By analyzing their own claims data, the report suggests that in 2010, the cost of genetic and molecular diagnostic testing for its members was about $500<\/p>\n","protected":false},"author":121,"featured_media":977,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5236,5757],"tags":[5739,5726,31856,31859,170],"_links":{"self":[{"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/posts\/936"}],"collection":[{"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/users\/121"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/comments?post=936"}],"version-history":[{"count":62,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/posts\/936\/revisions"}],"predecessor-version":[{"id":5456,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/posts\/936\/revisions\/5456"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/media\/977"}],"wp:attachment":[{"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/media?parent=936"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/categories?post=936"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/tags?post=936"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}