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Study Finds Genetic Testing Not Leading to Increased Use of Healthcare Services

NEW YORK (GenomeWeb News) – In spite of increased access to genetic testing, such tests do not drive up use of healthcare, according to a study published today in the early online edition of Genetics in Medicine.

The study looked at 1,599 continuously insured adults between the ages of 25 and 40 and offered them a multiplex genetic susceptibility test for eight common health conditions. Using electronic health records to compare how the survey subjects accessed healthcare services during a 12-month pre-test and 12-month post-test period, the study's authors found no statistical difference in how physician and/or medical testing was used in the post-test period among patients.

"Persons offered and completing multiplex genetic susceptibility testing used more physician visits before testing, but testing was not associated with subsequent changes in use," the study authors said. "This study supports the supposition that multiplex genetic testing offers can be provided directly to the patients in such a way that use of health services is not inappropriately increased."

The study included 217 people who chose to participate in genetic testing offered by their health plans and compared their behavior to a group of about 400 similar plan members who did not receive genetic testing.

To decipher utilization patterns, the researchers counted the number of doctor visits and laboratory tests and procedures study participants received, particularly services with four of eight conditions tested by the multiplex panel — type 2 diabetes mellitus, atherosclerotic coronary heart disease, colorectal cancer, and lung cancer.

Most of the procedures or screening tests that were not counted are not currently recommended for people in this age group who don't have symptoms.

The study was conducted by researchers with the Multiplex Initiative, comprised of scientists from the National Institutes of Health's Intramural Research Program, Group Health Cooperative in Seattle, and the Henry Ford Health System in Detroit. Launched in 2006, the Multiplex Initiative aims to better understand how the general public will use genetic information.

In the past five years, new genetic tests have been developed and marketed directly to consumers, raising concerns that such testing could lead to an inappropriate increased use of healthcare services, the study authors said. Little data exists on the impact of such tests on patient behavior, however.

"There are a lot of unanswered questions about how genetic test results can be used to guide people towards making positive lifestyle and health behavior changes," Colleen McBride, chief of the National Human Genome Research Institute's Social and Behavioral Research Branch, and one of the authors of the paper, said in a statement. "This study goes a long way towards bringing data to these debates and shows that people are not likely to make inappropriate demands of health delivery systems if they are properly informed about the limitations of genetic tests."

She and her colleagues wrote that while their research should allay the concerns of policy makers "interested in constraining costs" it may offer only a best-case scenario "reflective of the insured population we studied and the approach we took."

They further warn that the rapid growth of genomic advances and "shifts in their readiness for application in clinical practice could lead to genetic test offerings with impact on healthcare use that was not measured in our study. … To be of true benefit, these new genomic products should neither inappropriately increase healthcare costs nor amplify health disparities," the authors said.