Abstract
BackgroundIn vitro diagnostic (IVD) investigations are indispensable for routine patient management. Appropriate testing allows early-stage interventions, reducing late-stage healthcare expenditure (HCE).AimTo investigate HCE on IVDs in two developed markets and to assess the perceived value of IVDs on clinical decision-making. Physician-perceived HCE on IVD was evaluated, as well as desired features of new diagnostic markers.MethodsPast and current HCE on IVD was calculated for the US and Germany. A total of 79 US/German oncologists and cardiologists were interviewed to assess the number of cases where: physicians ask for IVDs; IVDs are used for initial diagnosis, treatment monitoring, or post-treatment; and decision-making is based on an IVD test result. A sample of 201 US and German oncologists and cardiologists was questioned regarding the proportion of HCE they believed to be attributable to IVD testing. After disclosing the actual IVD HCE, the physician’s perception of the appropriateness of the amount was captured. Finally, the association between physician-rated impact of IVD on decision-making and perceived contribution of IVD expenditure on overall HCE was assessed.ResultsIVD costs account for 2.3% and 1.4% of total HCE in the US and Germany. Most physicians (81%) believed that the actual HCE on IVDs was >5%; 19% rated the spending correctly (0–4%, p<0.001). When informed of the actual amount, 64% of physicians rated this as appropriate (p<0.0001); 66% of decision-making was based on IVD. Significantly, more physicians asked for either additional clinical or combined clinical/health economic data than for the product (test/platform) alone (p<0.0001).ConclusionsOur results indicate a poor awareness of actual HCE on IVD, but a high attributable value of diagnostic procedures for patient management. New markers should deliver actionable and medically relevant information, to guide decision-making and foster improved patient outcomes.
Highlights
In vitro diagnostic (IVD) testing has become an indispensable tool in clinical practice for diagnosing and monitoring of diseases, as well as providing prognosis and predicting treatment response [1, 2]
A sample of 201 US and German oncologists and cardiologists was questioned regarding the proportion of healthcare expenditure (HCE) they believed to be attributable to IVD testing
IVD costs account for 2.3% and 1.4% of total HCE in the US and Germany
Summary
In vitro diagnostic (IVD) testing has become an indispensable tool in clinical practice for diagnosing and monitoring of diseases, as well as providing prognosis and predicting treatment response [1, 2]. There are over 40,000 different IVD products available that provide information to doctors and patients on a huge range of conditions. These comprise markers for inorganic chemistry (electrolytes, toxins, and heavy metals), markers for organic chemistry/biochemistry (proteins, lipids, and carbohydrates), as well as molecular biologic procedures (sequencing and polymerase chain reaction). Routine diagnostics and population screening programs, such as the Pap smear for cervical carcinoma, have the potential to identify high-risk individuals and to prevent disease onset or progression [5, 6]. Appropriate testing allows early-stage interventions, reducing late-stage healthcare expenditure (HCE)
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