Showing posts with label costs. Show all posts
Showing posts with label costs. Show all posts

Monday, July 25, 2011

DNA Sequencing or Magnetic Resonance Imaging MRI

Today, one of the most common tests ordered in the United States is a Magnetic Resonance Image or MRI.  These images are typically ordered of a specific body part or region.  The cost of this type of test is variable ranging from $800 to over $3000 and produces exquisite information anatomic images.  

MRI of Torn Rotator Cuff

An MRI, however, gives the clinician no information about the patients systemic physiology or potential underlying risk factors.  If DNA sequencing can follow Moore's Law from computer science, then the cost should drop to $1000 within five years or perhaps less.  Databases are already being created with numbers reaching over 100,000 patients.  As the cost drops, physicians will begin ordering these tests almost as often as MRIs and we will then see dramatic shifts in the practice of medicine.  The natural history (what happens if no intervention occurs) is different for different patients.  We may be able to predict with DNA sequencing who will recover WITHOUT any specific or expensive treatment.  We also may be able to predict which patients will require aggressive treatment.  The era of personalized genomic medicine will have arrived.  This has broad implications for reducing the cost of care if implemented appropriately. 

Read more about the falling cost of DNA sequencing in the LA Times. 

AM










Sunday, April 24, 2011

Regenerative Medicine Treatment Value Equation

Regenerative medicine is a buzz phrase right now.  Patients, providers and politicians are all in favor of "Regenerative Medicine".  There are three major components to evaluate when assessing treatment value (TV).  Treatment value is directly related to overall efficacy (E) of the drug or procedure and inversely related to cost (C) and risk (R).  A simple equation can define it:

TV = E / C x R2

That is Treatment Value = Efficacy divided by Cost times Risk squared.

We need treatments of high value with maximal efficacy that have reasonable costs and minimal risks.  When evaluating new potential "Regenerative Medicine Treatments", consider this equation.

Please post any comments or suggestions.

AM
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