Study Shows Economic Utility of CardioDx Assay
CardioDx, the Palo Alto, Calif.-based laboratory that focuses on cardiovascular genomics testing, has issued a study concluding that its primary assay can save even a modestly sized health plan millions of dollars a year. The study focuses on Corus CAD, a molecular test that examines the 23 genes and their expressional changes related to the […]
CardioDx, the Palo Alto, Calif.-based laboratory that focuses on cardiovascular genomics testing, has issued a study concluding that its primary assay can save even a modestly sized health plan millions of dollars a year. The study focuses on Corus CAD, a molecular test that examines the 23 genes and their expressional changes related to the development of arteriosclerosis, the hardening of the arteries that can lead to heart attacks. It is 96 percent accurate in terms of ruling out obstructive coronary artery disease as a cause of chest pains and other potential symptoms related to heart disease. Coronary artery disease kills about 600,000 Americans a year and costs $109 billion in terms of health care delivery and lost productivity, according to data from the Centers for Disease Control and Prevention. The study, “Economic Utility of a Blood-Based Genomic Test for the Assessment of Patients with Symptoms Suggestive of Obstructive Coronary Artery Disease,” was published in the journal Population Health Management. The lead author was Louis Hochheiser, M.D., chief executive officer of St. John’s Medical Center in Jackson, Wyo., and a former medical director with health insurance giant Humana. The study concluded that use of the Corus test provides clearer treatment options for patients, leading to a cost savings of 9.4 percent compared to a less definitive path of care. Most of the savings was associated with the avoidance of noninvasive imaging and invasive diagnostics, such as myocardial perfusion imaging and cardiac angiography. The cost of both procedures can run well into the four figures for a single test. Employing the typical coronary care pathways in a health plan with 500,000 lives would cost $49.07 million a year. By employing the Corus test to provide a more accurate diagnosis, the savings is 77 cents per member per month, or $4.59 million a year, inclusive of the cost of administering and interpreting the assay. The cost savings includes nearly $5 million in avoiding unnecessary coronary angiographies and $1.7 million for stress myocardial perfusion imaging. “The results of this cost analysis indicate that the Corus CAD gene expression score, when used in primary care patients with symptoms suggestive of obstructive CAD, may reduce the economic burden associated with cardiac imaging and invasive coronary angiography, and allow patients to avoid unnecessary radiation exposure and complications associated with procedures,” said Joseph Ladapo, M.D., a professor at the New York University School of Medicine and co-author of the study. A variety of observers say such research is crucial for laboratories to make the case to the payer community regarding the economic utility of the tests they’re providing. Many are experiencing declining reimbursements from both public and private payers and often lack the leverage required to negotiate on equal terms with large insurers. In addition to its Corus test, CardioDx is also developing genomic tests related to congestive heart failure and cardiac arrhythmia. Takeaway: As clinical laboratories strive to prove the value of their services, the clinical and economic utility of laboratory tests can be made more clear with clinical research published in academic journals.