Friday, February 11, 2005

The Future of Medical Economics

Yesterday, while looking for something unrelated, I came across an article that discussed a genetic test that could predict the occurrence of Stevens-Johnson syndrome (SJS) in persons being treated with a prescription drug, carbamazepine (Tegretol).  This is not a subject of general interest, really, since carbamazepine (CBZ) is being used less often now, and the condition occurs only 8 times in 1,000,000 patient-years of exposure. 

It got me to think about the economics of the testing.  Genetic testing tends to be very expensive.  I wondered if it ever would be feasible to do such testing routinely, before starting treatment with a medication.  How much would it cost to prevent one case of Stevens-Johnson syndrome?   What is interesting here is not so much the specific case of CBZ and the risk of SJS.  Rather, what if we someday have a panel of genetic tests that could be used to predict both positive and negative responses to medications in individual patients?  That would be great, but it would cost an awful lot.  This kind of thing is one of the reasons that the cost of medical care keeps going up, and obviously, we have to draw the line somewhere.   And why is it that these things always seem to drive costs up?  In the computer industry, innovations always seem to drive costs down.  Why can't that happen in medicine?  Read the rest at The Rest of the Story.