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Patient preferences and National Health Service costs: a cost-consequences analysis of cancer genetic services

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Abstract

The study has three aims; firstly to establish if, having been informed of their risk status and that gene testing is inappropriate for them, low and moderate risk patients have misunderstood or failed to grasp this and want a test that is inappropriate for them. Secondly, to elicit patients’ willingness to pay for cancer genetic services. Thirdly, to ascertain the aspects of cancer genetics services that are important to high risk patients and present service configurations prioritised in terms of preferences accompanied by their costs (cost-consequences analysis). Patient preferences were gathered from 120 patients returning a self-administered discrete choice questionnaire issued post genetic risk assessment. Patients at low and moderate risk of developing breast cancer desired inappropriate testing. Patients at high, moderate and low risk of developing genetic cancer were willing to pay up to £3,000 for genetic serviced, which exceeds the current estimated cost of providing testing and counselling. Counselling by a genetics associate accompanied by favourable levels of other attributes provided high utility and substantial cost savings.

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Abbreviations

CGSW:

Cancer Genetics Service in Wales

DCM:

Discrete choice modelling

FAP or FAPC:

Familial adenomatous polyposis coli

GP:

General practitioner

HNPCC:

Hereditary nonpolyposis colorectal cancer

NHS:

National Health Service

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Acknowledgements

We are grateful to all the patients and staff of the Cancer Genetics Service in Wales that participated in this research. We also wish to thank the anonymous reviewers for their valuable comments.

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Authors and Affiliations

  1. Health Economics Research Group, Brunel University, Uxbridge, Middlesex, UB8 3PH, UK

    Gethin L. Griffith

  2. Centre for Economics and Policy in Health, Institute of Medical and Social Care Research, Bangor University, Bangor, UK

    Rhiannon Tudor Edwards

  3. Department of Psychiatry, University of Oxford, Oxford, UK

    J. Mark G. Williams

  4. Wales Centre for Health and Institute of Medical Genetics, Cardiff, UK

    Jonathon Gray

  5. School of Psychology, Bangor University, Bangor, UK

    Val Morrison

  6. Department of General Practice, North Wales Section, University of Wales College of Medicine, Wrexham Technology Park, Wrexham, UK

    Clare Wilkinson, Jim Turner & Barbara France

  7. Cardiff School of Nursing and Midwifery Studies, Cardiff University, Cardiff, UK

    Paul Bennett

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  1. Gethin L. Griffith
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Correspondence to Gethin L. Griffith.

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Griffith, G.L., Edwards, R.T., Williams, J.M.G. et al. Patient preferences and National Health Service costs: a cost-consequences analysis of cancer genetic services. Familial Cancer 8, 265–275 (2009). https://doi.org/10.1007/s10689-008-9217-5

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  • DOI: https://doi.org/10.1007/s10689-008-9217-5

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