TY - JOUR

T1 - Ganzgenomsequenzierung in der deutschen Versorgung

T2 - Ökonomische Auswirkungen eines Einsatzes in ausgewählten Anwendungsgebieten

AU - Plöthner, Marika

AU - Frank, Martin

AU - Graf von der Schulenburg, J. Matthias

N1 - Publisher Copyright: © 2016, Springer-Verlag Berlin Heidelberg. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.

PY - 2017/2

Y1 - 2017/2

N2 - Background: The diagnostic use of whole-genome sequencing (WGS) is a growing issue in medical care. Due to limited resources in public health service, budget-impact analyses are necessary prior to implementation. Objective: A budget-impact analysis for WGS of all newborns and diagnostic investigation of tumor patients in different oncologic indications were evaluated. Methods: A cost analysis of WGS based on a quality-assured process chart for WGS at the German Cancer Research Center (DKFZ), Heidelberg, constitutes the basis for this evaluation. Data from the National Association of Statutory Health Insurance Funds and the Robert-Koch-Institute, Berlin, were used for calculations of specific clinical applications. Results and discussion: WGS in newborn screening leads to costs of € 2.85 bn and to an increase of total expenditure by 1.41%. Sequencing of all tumor patients would cost approximately € 0.84 bn, which corresponds to 0.42% of total expenditures. In all scenarios, the sole consideration of procedure costs results in increasing costs. However, in cost discussions potential savings (reduction of disease-related follow-up-costs, improved cost-effectiveness of medical measures etc.) should be considered. Such considerations are the subject of economic indication-specific evaluations. WGS has the potential to generate a large number of deterministic findings for which treatment options are limited. Hence, it is necessary to limit indications, in which WGS has proven medical evidence.

AB - Background: The diagnostic use of whole-genome sequencing (WGS) is a growing issue in medical care. Due to limited resources in public health service, budget-impact analyses are necessary prior to implementation. Objective: A budget-impact analysis for WGS of all newborns and diagnostic investigation of tumor patients in different oncologic indications were evaluated. Methods: A cost analysis of WGS based on a quality-assured process chart for WGS at the German Cancer Research Center (DKFZ), Heidelberg, constitutes the basis for this evaluation. Data from the National Association of Statutory Health Insurance Funds and the Robert-Koch-Institute, Berlin, were used for calculations of specific clinical applications. Results and discussion: WGS in newborn screening leads to costs of € 2.85 bn and to an increase of total expenditure by 1.41%. Sequencing of all tumor patients would cost approximately € 0.84 bn, which corresponds to 0.42% of total expenditures. In all scenarios, the sole consideration of procedure costs results in increasing costs. However, in cost discussions potential savings (reduction of disease-related follow-up-costs, improved cost-effectiveness of medical measures etc.) should be considered. Such considerations are the subject of economic indication-specific evaluations. WGS has the potential to generate a large number of deterministic findings for which treatment options are limited. Hence, it is necessary to limit indications, in which WGS has proven medical evidence.

KW - Budget-impact analyses

KW - Genetic diagnostics

KW - Newborn screening

KW - Oncology

KW - Whole-genome sequencing

UR - http://www.scopus.com/inward/record.url?scp=85006716963&partnerID=8YFLogxK

U2 - 10.1007/s00103-016-2492-7

DO - 10.1007/s00103-016-2492-7

M3 - Artikel

C2 - 27999872

AN - SCOPUS:85006716963

VL - 60

SP - 143

EP - 150

JO - Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz

JF - Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz

SN - 1436-9990

IS - 2

ER -