What can laparoscopic cholecystectomy teach us about genomic testing? Read here to find out http://t.co/TBdTarqNDk— Peter Ubel (@peterubel) 26 agost, 2014
Peter Ubel is a researcher at Duke University in North Carolina and author of "Critical Decisions" book. We already had a post mentioning Dr Ubel: "Teaching patients to make the timely question." Now, along with that tweet, he sent us to a post written by himself on the Forbes magazine blog which analyzes the impact of plummeting prices for the genome test.
To illustrate his concerns, Dr. Ubel remembered what happened when laparoscopy was introduced as a means of intervention for cholecystectomy. "Costs per process were reduced by reducing hospital stay of patients undergoing surgery, but the number of interventions increased by 20%, and this was explained because as the new technique was simpler, many patients with gallbladder stones, but without symptoms, found it easier to decide to undergo surgery.”
What will happen now that the genome test is cheaper? According to the author, in some chemotherapy treatments we’ll have the illusion of reduced costs per process, because, in theory, the drugs can be adjusted to the specific metabolism of each person, at least according to the part revealed by the genome. If things will indeed end up being so, says Dr. Ubel, no doubt that for chemotherapy affected by reduced consumption, the prices will skyrocket.
Another, no less important question he points out in the article, is that the application of the genome, already cheaper, in the quest for rare diseases may lead to an escalation of diagnostic tests motivated by suspicions of genome mutations difficult to interpret. Despite these caveats, the author believes that genomics can bring new expectations for the always difficult industry of orphan treatments.
Now the genome test is within our reach. Good news, right? Hopefully yes, but if we don’t know how to separate the wheat from the chaff, this novelty can ruin public budgets all the time we’re not finding it a useful role for improving the health of certain minority groups of patients.