Cost Efficacy of Rapid Whole Genome Sequencing in the Pediatric Intensive Care Unit
The diagnostic and clinical utility of rapid whole genome sequencing (rWGS) for critically ill children in the intensive care unit (ICU) has been substantiated by multiple studies, but comprehensive cost-effectiveness evaluation of rWGS in the ICU outside of the neonatal age group is lacking. In thi...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2021.809536/full |
| _version_ | 1818976433330978816 |
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| author | Erica Sanford Kobayashi Erica Sanford Kobayashi Bryce Waldman Branden M. Engorn Katherine Perofsky Katherine Perofsky Erika Allred Erika Allred Benjamin Briggs Chelsea Gatcliffe Nanda Ramchandar Nanda Ramchandar Jeffrey J. Gold Jeffrey J. Gold Ami Doshi Ami Doshi Elizabeth G. Ingulli Courtney D. Thornburg Courtney D. Thornburg Wendy Benson Lauge Farnaes Shimul Chowdhury Seema Rego Charlotte Hobbs Stephen F. Kingsmore David P. Dimmock Nicole G. Coufal Nicole G. Coufal Nicole G. Coufal |
| author_facet | Erica Sanford Kobayashi Erica Sanford Kobayashi Bryce Waldman Branden M. Engorn Katherine Perofsky Katherine Perofsky Erika Allred Erika Allred Benjamin Briggs Chelsea Gatcliffe Nanda Ramchandar Nanda Ramchandar Jeffrey J. Gold Jeffrey J. Gold Ami Doshi Ami Doshi Elizabeth G. Ingulli Courtney D. Thornburg Courtney D. Thornburg Wendy Benson Lauge Farnaes Shimul Chowdhury Seema Rego Charlotte Hobbs Stephen F. Kingsmore David P. Dimmock Nicole G. Coufal Nicole G. Coufal Nicole G. Coufal |
| author_sort | Erica Sanford Kobayashi |
| collection | DOAJ |
| description | The diagnostic and clinical utility of rapid whole genome sequencing (rWGS) for critically ill children in the intensive care unit (ICU) has been substantiated by multiple studies, but comprehensive cost-effectiveness evaluation of rWGS in the ICU outside of the neonatal age group is lacking. In this study, we examined cost data retrospectively for a cohort of 38 children in a regional pediatric ICU (PICU) who received rWGS. We identified seven of 17 patients who received molecular diagnoses by rWGS and had resultant changes in clinical management with sufficient clarity to permit cost and quality adjusted life years (QALY) modeling. Cost of PICU care was estimated to be reduced by $184,846 and a total of 12.1 QALYs were gained among these seven patients. The total cost of rWGS for patients and families for the entire cohort (38 probands) was $239,400. Thus, the net cost of rWGS was $54,554, representing $4,509 per QALY gained. This quantitative, retrospective examination of healthcare utilization associated with rWGS-informed medicine interventions in the PICU revealed approximately one-third of a QALY gained per patient tested at a cost per QALY that was approximately one-tenth of that typically sought for cost-effective new medical interventions. This evidence suggests that performance of rWGS as a first-tier test in selected PICU children with diseases of unknown etiology is associated with acceptable cost-per-QALY gained. |
| first_indexed | 2024-12-20T16:11:46Z |
| format | Article |
| id | doaj.art-e4d764dcb81347038e600251a1741c59 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-20T16:11:46Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-e4d764dcb81347038e600251a1741c592022-12-21T19:33:58ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-01-01910.3389/fped.2021.809536809536Cost Efficacy of Rapid Whole Genome Sequencing in the Pediatric Intensive Care UnitErica Sanford Kobayashi0Erica Sanford Kobayashi1Bryce Waldman2Branden M. Engorn3Katherine Perofsky4Katherine Perofsky5Erika Allred6Erika Allred7Benjamin Briggs8Chelsea Gatcliffe9Nanda Ramchandar10Nanda Ramchandar11Jeffrey J. Gold12Jeffrey J. Gold13Ami Doshi14Ami Doshi15Elizabeth G. Ingulli16Courtney D. Thornburg17Courtney D. Thornburg18Wendy Benson19Lauge Farnaes20Shimul Chowdhury21Seema Rego22Charlotte Hobbs23Stephen F. Kingsmore24David P. Dimmock25Nicole G. Coufal26Nicole G. Coufal27Nicole G. Coufal28Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesRady Children's Hospital San Diego, San Diego, CA, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesRady Children's Hospital San Diego, San Diego, CA, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesRady Children's Hospital San Diego, San Diego, CA, United StatesNaval Medical Center San Diego, San Diego, CA, United StatesMcGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesRady Children's Hospital San Diego, San Diego, CA, United StatesRady Children's Hospital San Diego, San Diego, CA, United StatesDepartment of Neuroscience, University of California, San Diego, San Diego, CA, United StatesRady Children's Hospital San Diego, San Diego, CA, United StatesDepartment of Pediatrics, University of California, San Diego, San Diego, CA, United StatesRady Children's Hospital San Diego, San Diego, CA, United StatesRady Children's Hospital San Diego, San Diego, CA, United StatesDepartment of Pediatrics, University of California, San Diego, San Diego, CA, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesDepartment of Infectious Disease, University of California, San Diego, San Diego, CA, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesRady Children's Institute for Genomic Medicine, San Diego, CA, United StatesRady Children's Hospital San Diego, San Diego, CA, United StatesDepartment of Pediatrics, University of California, San Diego, San Diego, CA, United StatesThe diagnostic and clinical utility of rapid whole genome sequencing (rWGS) for critically ill children in the intensive care unit (ICU) has been substantiated by multiple studies, but comprehensive cost-effectiveness evaluation of rWGS in the ICU outside of the neonatal age group is lacking. In this study, we examined cost data retrospectively for a cohort of 38 children in a regional pediatric ICU (PICU) who received rWGS. We identified seven of 17 patients who received molecular diagnoses by rWGS and had resultant changes in clinical management with sufficient clarity to permit cost and quality adjusted life years (QALY) modeling. Cost of PICU care was estimated to be reduced by $184,846 and a total of 12.1 QALYs were gained among these seven patients. The total cost of rWGS for patients and families for the entire cohort (38 probands) was $239,400. Thus, the net cost of rWGS was $54,554, representing $4,509 per QALY gained. This quantitative, retrospective examination of healthcare utilization associated with rWGS-informed medicine interventions in the PICU revealed approximately one-third of a QALY gained per patient tested at a cost per QALY that was approximately one-tenth of that typically sought for cost-effective new medical interventions. This evidence suggests that performance of rWGS as a first-tier test in selected PICU children with diseases of unknown etiology is associated with acceptable cost-per-QALY gained.https://www.frontiersin.org/articles/10.3389/fped.2021.809536/fullgenomic sequencingrapid whole genome sequencingpediatric intensive carecritical carecost analysishealth economics |
| spellingShingle | Erica Sanford Kobayashi Erica Sanford Kobayashi Bryce Waldman Branden M. Engorn Katherine Perofsky Katherine Perofsky Erika Allred Erika Allred Benjamin Briggs Chelsea Gatcliffe Nanda Ramchandar Nanda Ramchandar Jeffrey J. Gold Jeffrey J. Gold Ami Doshi Ami Doshi Elizabeth G. Ingulli Courtney D. Thornburg Courtney D. Thornburg Wendy Benson Lauge Farnaes Shimul Chowdhury Seema Rego Charlotte Hobbs Stephen F. Kingsmore David P. Dimmock Nicole G. Coufal Nicole G. Coufal Nicole G. Coufal Cost Efficacy of Rapid Whole Genome Sequencing in the Pediatric Intensive Care Unit Frontiers in Pediatrics genomic sequencing rapid whole genome sequencing pediatric intensive care critical care cost analysis health economics |
| title | Cost Efficacy of Rapid Whole Genome Sequencing in the Pediatric Intensive Care Unit |
| title_full | Cost Efficacy of Rapid Whole Genome Sequencing in the Pediatric Intensive Care Unit |
| title_fullStr | Cost Efficacy of Rapid Whole Genome Sequencing in the Pediatric Intensive Care Unit |
| title_full_unstemmed | Cost Efficacy of Rapid Whole Genome Sequencing in the Pediatric Intensive Care Unit |
| title_short | Cost Efficacy of Rapid Whole Genome Sequencing in the Pediatric Intensive Care Unit |
| title_sort | cost efficacy of rapid whole genome sequencing in the pediatric intensive care unit |
| topic | genomic sequencing rapid whole genome sequencing pediatric intensive care critical care cost analysis health economics |
| url | https://www.frontiersin.org/articles/10.3389/fped.2021.809536/full |
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