Is faster better? An economic evaluation of rapid and ultra-rapid genomic testing in critically ill infants and children

Genet Med. 2022 May;24(5):1037-1044. doi: 10.1016/j.gim.2022.01.013. Epub 2022 Feb 16.

Abstract

Purpose: To evaluate whether the additional cost of providing increasingly faster genomic results in pediatric critical care is outweighed by reductions in health care costs and increases in personal utility.

Methods: Hospital costs and medical files from a cohort of 40 children were analyzed. The health economic impact of rapid and ultra-rapid genomic testing, with and without early initiation, relative to standard genomic testing was evaluated.

Results: Shortening the time to results led to substantial economic and personal benefits. Early initiation of ultra-rapid genomic testing was the most cost-beneficial strategy, leading to a cost saving of AU$26,600 per child tested relative to standard genomic testing and a welfare gain of AU$12,000 per child tested. Implementation of early ultra-rapid testing of critically ill children is expected to lead to an annual cost saving of AU$7.3 million for the Australian health system and an aggregate welfare gain of AU$3.3 million, corresponding to a total net benefit of AU$10.6 million.

Conclusion: Early initiation of ultra-rapid genomic testing can offer substantial economic and personal benefits. Future implementation of rapid genomic testing programs should focus not only on optimizing the laboratory workflow to achieve a fast turnaround time but also on changing clinical practice to expedite test initiation.

Keywords: Children; Cost-benefit; Cost-effectiveness; Genomics; Rare diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia
  • Child
  • Cost-Benefit Analysis
  • Critical Care*
  • Critical Illness*
  • Genetic Testing / methods
  • Humans
  • Infant