A new UnitedHealthcare study finds that few Americans have undergone genetic testing, but that, increasingly, physicians say they will be using the diagnostics in their practices.
Overall national spending on genetic testing was about $5 billion in 2010, which is only 8% of spending on clinical lab services, according to UnitedHealthcare’s study. Spending should rise to $15 billion to 20 billion by 2021, said the insurer, which studied genetic testing using its own data and an analysis of Medicare and Medicaid fee-for-service data, as well as by conducting surveys of patients and physicians.
The insurer estimates that there are 1,000-1,300 tests available for 2,500 conditions, and that several new tests are being developed each month. UnitedHealthcare said it spent $500 million on testing for its members in 2010 (40% on testing for infectious diseases, 16% for cancer, and the rest for other conditions including inherited disorders).
Testing use per person was highest in UnitedHealthcare’s Medicaid population, followed by its commercially insured and then its Medicare populations. Cancer diagnostics, however, were used at a higher rate in the Medicare population, reflecting "greater risk and incidence of cancer in senior populations."
Molecular and genetic testing increased by 14% per year from 2008 to 2010.
Two surveys that were commissioned by UnitedHealthcare and conducted by Harris Interactive in January and February found that Americans have a positive view of genetic testing, with 71% saying they were familiar with testing, but only 6% saying they’d had such a test. In all, 3% were unsure whether they’d been tested. About half said that they were "knowledgeable" about "genetic science." The vast majority said that the number of tests available and the amount of testing conducted will increase in 5 years.
UnitedHealthcare reported that 63% of physicians said that testing helped them to diagnose undetected conditions. Overall, 75% of physicians said that testing could benefit patients in their practices, but only 4% of their patients had been tested. They expected that figure to rise to 14% of patients in 5 years.
Three-quarters of physicians said they were "somewhat knowledgeable" about genetic science; 7% said they are "very knowledgeable," and 16% said they were "not knowledgeable."
Meanwhile, they said that 72% of their patients are "somewhat able" to understand results. Physicians thought that 7% were "not at all able to understand" genetic test results.
Some 59% of doctors said that they are concerned about the cost of genetic tests for their patients, whereas only 21% said they worried about their own reimbursement. In all, 56% said they expected genetic testing to increase overall health spending, compared with 19% who said it would cut costs. The majority said that testing would improve care.