In the past, percussion of the abdomen, taking temperature, or tasting sugar in urine were considered diagnostic standard of care methodologies. Today, invitro diagnostics (IVD) provide additional objective biomarkers that diagnose cancer, infections, heart attacks and many other health conditions.
IVD is a collection of several technologies, mostly developed over the past hundred years. It is an important part of healthcare, but only a small contributor to health care cost. To illustrate this, in 2012 €40 billion was spent on IVDs, which is approximately one-twentieth (or 5%) of what was spent on pharmaceutical products in the same year.
We firmly believe that IVDs represent an inexpensive route towards more accurate and rapid patient care, translating into potential reductions in procedural and therapeutic costs. Policies that ignore the wide range of IVD technologies and the complexities of the IVD application inflate health care cost and hurt patients.
One example of IVD’s role in healthcare cost reduction is the use of better cardiac markers in the emergency department. Low risk patients can be identified with the help of IVD tests. Those low risk patients can be sent home safely and do not need to occupy hospital beds. William Frank Peacock, MD, Baylor College of Medicine, summarized data from two trials – ADAPT and APACE[1] – at the 2013 Annual Meeting of the American Association for Clinical Chemistry (AACC) that showed the benefits of better cardiac markers. These trials demonstrated that about 22% of patients could be safely sent home based on a combination of ECG and an improved IVD test. 320 of the 1635 patient for ADAPT and 230 of the 909 APACE-enrolled patients did not need to occupy a hospital bed.
What does this mean for healthcare cost? The cost of a bed is more than €2,000 per day and patients often remain hospitalized for several days. We estimate that in developed countries more than 2.5 million patients are admitted to hospitals with chest pain.[2] If we can send 22% of those chest-pain patients home safely one day early we save more than €1 billion in annual healthcare expenses. Based on the ADAPT and APACE results, 22% don’t have to be admitted in the first place and therefore multiple hospitalization days are saved per patient, which means multiple billion Euros can be saved.
This is only one example that shows how one IVD reduces healthcare cost and improves quality of life by avoiding unnecessary hospitalization. It demonstrates how expanding IVD testing and frequency has the potential to improve healthcare outcomes and lower healthcare delivery cost.
–Manfred Scholze and Bryce Sady, Scholze Consulting Partners LLC
[1] Cullen L. JACC, 2013. 10.1016/j.jacc.2013.02.078
[2] Heart. 2005 February; 91(2): 229–230. 10.1136/hrt.2003.027599