Cost-effectiveness analysis of genetic testing for familial long QT syndrome in symptomatic index cases
Received 22 March 2005; accepted 26 August 2005. published online 03 September 2005.
Background
Genetic testing for long QT syndrome (LQTS) has been available in a research setting for the past decade, and a commercial test has recently become available. However, the costs and effectiveness of genetic testing have not been estimated.
Objectives
The purpose of this study was to conduct a cost-effectiveness analysis of genetic testing in the management of patients who have or are suspected to have familial LQTS.
Methods
We examined the incremental cost-effectiveness of genetic testing compared with no genetic testing for symptomatic index cases and how this varied according to changes in assumptions and data inputs. Data were obtained from the published literature and a clinical cohort.
Results
We found that genetic testing is more cost-effective than not testing for symptomatic index cases at an estimated cost of $2,500 per year of life saved. These results were generally robust, although they were sensitive to some data inputs such as the cost of testing and the mortality rate among untreated individuals with LQTS.
Conclusion
A genetic test for familial LQTS is cost-effective relative to no testing, given our assumptions about the population to be tested and the relevant probabilities and costs. The primary benefit of testing is to more accurately diagnose and treat individuals based on a combination of clinical scores and test results. Future economic analyses of testing for familial LQTS should consider the potential benefits of genetic testing of broader populations, including family members.
aSchool of Pharmacy, Institute for Health Policy Studies, and UCSF Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
bDepartments of Medicine, Pediatrics, and Molecular Pharmacology, Divisions of Cardiovascular Diseases and Pediatric Cardiology, Mayo Clinic College of Medicine, Rochester, Minnesota
cSutter Health Institute for Research and Education, San Francisco, California
dDepartment of Cardiology, Children’s Hospital Boston and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
Address reprint requests and correspondence: Dr. Kathryn A. Phillips, School of Pharmacy, Institute for Health Policy Studies, and UCSF Comprehensive Cancer Center, University of California, San Francisco, 3333 California Street #420, Box 0613, San Francisco, California 94143.
Partial funding was provided by Genaissance Pharmaceuticals, Inc., through independent consulting contracts to Dr. Phillips and Dr. Ackerman. All results and conclusions are those of the authors and should not be construed to represent those of Genaissance Pharmaceuticals.
⁎ Dr. Sakowski was located at the University of California, San Francisco, when much of this research was completed.
ABSTRACT