Impacts of genomics on the health and social costs of intellectual disability

被引:10
作者
Doble, Brett [1 ,2 ]
Schofield, Deborah [1 ,3 ]
Evans, Carey-Anne [4 ]
Groza, Tudor [5 ]
Mattick, John S. [1 ,6 ]
Field, Mike [7 ]
Roscioli, Tony [4 ,8 ]
机构
[1] Garvan Inst Med Res, Darlinghurst, NSW 2010, Australia
[2] Duke NUS Med Sch, Programme Hlth Serv & Syst Res, Singapore, Singapore
[3] Macquarie Univ, Fac Business & Econ, Sch Econ, GenImpact, Sydney, NSW, Australia
[4] Univ New South Wales, Prince Wales Clin Sch, Neurosci Res Australia, Randwick, NSW, Australia
[5] Pryzm Hlth, Gold Coast, Qld, Australia
[6] Univ New South Wales, St Vincents Clin Sch, Sydney, NSW, Australia
[7] Genet Learning Disabil Serv, Waratah, NSW, Australia
[8] Prince Wales Private Hosp, NSW Hlth Pathol East Lab, Randwick, NSW, Australia
基金
英国医学研究理事会;
关键词
cost analysis; intellectual disability; monogenic disorders; population genomic sequencing; whole-genome sequencing; YOUNG-PEOPLE; PHYSICAL-DISABILITIES; CHALLENGING BEHAVIOR; DIAGNOSTIC YIELD; SERVICE USE; DISORDERS; CHILDREN; ADULTS; CARE; COMMUNITY;
D O I
10.1136/jmedgenet-2019-106445
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Background This study provides an integrated assessment of the economic and social impacts of genomic sequencing for the detection of monogenic disorders resulting in intellectual disability (ID). Methods Multiple knowledge bases were cross-referenced and analysed to compile a reference list of monogenic disorders associated with ID. Multiple literature searches were used to quantify the health and social costs for the care of people with ID. Health and social expenditures and the current cost of whole-exome sequencing and whole-genome sequencing were quantified in relation to the more common causes of ID and their impact on lifespan. Results On average, individuals with ID incur annual costs in terms of health costs, disability support, lost income and other social costs of US$172 000, accumulating to many millions of dollars over a lifetime. Conclusion The diagnosis of monogenic disorders through genomic testing provides the opportunity to improve the diagnosis and management, and to reduce the costs of ID through informed reproductive decisions, reductions in unproductive diagnostic tests and increasingly targeted therapies.
引用
收藏
页码:479 / 486
页数:8
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