The new genetics — Options in costing exercises

There has recently been a large increase in the numbers of genetic disorders capable of being diagnosed antenatally. Already the demand on some research orientated services is outstripping supply and, as the tests become more widely known, the demand amongst high risk families is likely to increase significantly. Regional or supra-Regional laboratories need to ascertain whether a service offered to high risk families will be cost beneficial. This background paper summarises the options open. Four approaches are possible: (1) A full cost benefit analysis is being undertaken at certain centres. (2) An attempt at a cost benefit analysis based on ‘guesstimates’. (3) The use of data from hospital activity analysis and ‘minimal’ hospital costs estimated to see if, in hospital savings alone, such a screening programme could be cost beneficial. (4) The cost per case prevented can be estimated for certain genetic disorders and some judgment made as to how ‘reasonable’ this expenditure is. This is the simplest of the options and is considered in detail in this paper. The cost per case terminated using this method is approximately £4,000.