WILL GENOME SEQUENCING MAKE HEALTH CARE CHEAPER?
Many drugs cost hundreds of thousands of dollars per year. Wouldn’t delivery of the right drugs to the right patients save a lot of money? In some areas, the answer is very likely to be, “Yes.” In the cancer area, giving expensive drugs that can cost $100,000 or more for the course of treatment to patients when they are not likely to respond will realize a considerable cost in savings. (See Table 1 for examples of expensive drugs provided by Medicare.) Similarly, catching individuals with heart or coronary artery problems prior to a heart attack or stroke is likely to reduce these adverse events and help those who might otherwise go on long-term support to live a more productive and healthier life. Solving undiagnosed diseases will cut down on many futile tests as well as on considerable anxiety.
Table 1. Medicare spent $19.5 billion for drugs administered by physicians or “outpatients” (Part B drugs) in 2010. The 10 most expensive drugs per year are shown in this Table and account for 45% of the total costs of Part B drugs. (According to the Government Accountability Office, and can cost over $200,000 per treatment.
|Factor viii Recombinant||Hemophilia A||$216,833|
|Remodulin||Pulmonary arterial hypertension||$130,772|
|Ventavis||Pulmonary arterial hypertension||$84,205|
|Primacor||Acute decompensated heart failure||$62,790|
|Sandostatin LAR Depot||Acromegaly, diarrhea, and flushing caused by cancerous tumors and vasoactive intestinal peptide secreting adenomas||$22,748|
In other areas, genome sequencing is less likely to result in an overall cost savings. Most undiagnosed diseases are not solved by genome sequencing and even if they are, this does not lead to therapies and can result in an additional set of follow-up tests. In the case of preventative medicine, although we expect that most people will find value in genome sequencing for managing their health, it will most likely postpone an adverse event, but may not ultimately save funds in the long term. In this respect, we expect that overall genome sequencing will improve the management of people’s health by catching disease early and helping give the right drugs to the right people, but it may not necessarily save money for the system overall. In many cases, the real savings will be in the quality of health care.