Patient preferences and National Health Service costs: a cost-consequences analysis of cancer genetic services

• Published in: Familial cancer 2009-12, Vol.8 (4), p.265-275
• Main Authors: Griffith, Gethin L., Edwards, Rhiannon Tudor, Williams, J. Mark G., Gray, Jonathon, Morrison, Val, Wilkinson, Clare, Turner, Jim, France, Barbara, Bennett, Paul
• Format: Article
• Language: English
• Subjects: Biomedical and Life Sciences; Biomedicine; Breast Neoplasms - economics; Breast Neoplasms - genetics; Cancer Research; Costs and Cost Analysis - economics; Epidemiology; Female; Genetic Predisposition to Disease; Genetic Services - economics; Human Genetics; Humans; National Health Programs - economics; Patient Preference - economics; United Kingdom
• ISSN: 1389-9600; 1573-7292
• DOI: 10.1007/s10689-008-9217-5

The study has three aims; firstly to establish if, having been informed of their risk status and that gene testing is inappropriate for them, low and moderate risk patients have misunderstood or failed to grasp this and want a test that is inappropriate for them. Secondly, to elicit patients’ willingness to pay for cancer genetic services. Thirdly, to ascertain the aspects of cancer genetics services that are important to high risk patients and present service configurations prioritised in terms of preferences accompanied by their costs (cost-consequences analysis). Patient preferences were gathered from 120 patients returning a self-administered discrete choice questionnaire issued post genetic risk assessment. Patients at low and moderate risk of developing breast cancer desired inappropriate testing. Patients at high, moderate and low risk of developing genetic cancer were willing to pay up to £3,000 for genetic serviced, which exceeds the current estimated cost of providing testing and counselling. Counselling by a genetics associate accompanied by favourable levels of other attributes provided high utility and substantial cost savings.