Measuring the economic value of genetic counselling

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The introduction of new genetic sequencing technologies and other advances in genomics are likely to stimulate the development of new models of service delivery for genetic counselling, perhaps in some instances, moving genomics into mainstream care. New models of service delivery for genetic counselling will compete with existing traditional approaches and also other uses of finite budgets for healthcare provision. Within this context of evolving models of genetic, and perhaps genomic, counselling we describe if, and how, it is possible to measure their economic value to support the informed introduction of new models of service delivery for genetic counselling into healthcare systems. We outline the need to be cognisant of opportunity cost and how methods of economic evaluation can be used to provide evidence of the incremental costs and consequences of models of service delivery for genetic counselling that can be best described as a complex intervention. We provide a brief description of the two main types of economic evaluation, cost effectiveness analysis and cost benefit analysis, and the underlying normative foundations of these methods. We then describe how to begin to value the consequences of genetic counselling, which addresses similar challenges posed by other complex interventions that can result in consequences other than health status as measured by the EQ5D and Quality Adjusted Life Year (QALYs). To date, no practical solution exists to value consequences beyond health status and which accounts for opportunity cost. A taxonomy of value when using an intervention for the provision of genomic-based diagnostic information has been suggested but further empirical work is, however, necessary to understand if, and by how much, society is willing to offset such gains against health status to measure the economic value of genetic counselling.
Original languageEnglish
JournalEuropean journal of medical genetics
Early online date14 Dec 2018
Publication statusPublished - 2018


  • Genetic counselling
  • Cost effectiveness analysis
  • Cost benefit analysis
  • Opportunity cost
  • Value
  • Capability
  • Complex intervention


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