Genetic Test Availability And Spending: Where Are We Now? Where Are We Going?

TLDR

Since the 2003 human genome mapping, genetic testing and its spending have expanded rapidly, yet the number of tests, their utilization, and payment mechanisms remain largely undocumented. The study aims to illuminate the genetic testing landscape by providing an overview of test availability and usage. Using unique data on test availability and commercial payer spending for privately insured populations, the authors examined the full spectrum of genetic tests, especially multi‑gene tests, from 2014 to 2017. The analysis revealed roughly 75,000 genetic tests on the market, with about ten new tests entering daily, and prenatal tests dominated spending, followed by hereditary cancer tests, offering insights for market assessment and policy debates.

Abstract

Genetic testing and spending on that testing have grown rapidly since the mapping of the human genome in 2003. However, it is not widely known how many tests there are, how they are used, and how they are paid for. Little evidence from large data sets about their use has emerged. We shed light on the issue of genetic testing by providing an overview of the testing landscape. We examined test availability and spending for the full spectrum of genetic tests, using unique data sources on test availability and commercial payer spending for privately insured populations, focusing particularly on tests measuring multiple genes in the period 2014–17. We found that there were approximately 75,000 genetic tests on the market, with about ten new tests entering the market daily. Prenatal tests accounted for the highest percentage of spending on genetic tests, and spending on hereditary cancer tests accounted for the second-highest. Our results provide insights for those interested in assessing genetic testing markets, test usage, and health policy implications, including current debates over the most appropriate regulatory and payer coverage mechanisms.