Tuesday, 5 March 2013

What other medical tests could you buy with a $1000 genome

There is lots of discussion about the $1000 genome, what it means, what its impact might be, etc.

First off though deciding what a $1000 genome means seems to be almost impossible given everybody uses different ways to calculate costs. In a soon to be published review article we pointed to the 2011 Sboner et al paper that stated a cost of $6500, and we suggest that today a genome costs about $4000 for 30x coverage. Whether you include instrument amortisation as well as data analysis costs makes a huge difference to the final figure. Is it really closer to $25,000?

Even so a "$1000 genome" can be compared to current medical tests and in this post I've put together a list of ten common tests ranging in cost as comparators. I was surprised at the costs of some tests and can see even NGS based tests coming in at well under $100 (about the same as an ultrasound), and perhaps even $10 in the future (at the same as a pregnancy test).

The price of medical tests:
 Robotic surgery to remove prostate £10,000
Standard course of chemotherapy £5000-10,000
BRCA test or Oncotype DX £2,800
Cancer gene sequencing (all exons) £1000
Overnight stay in Hospital £400
CT scan £400
MRI scan £300
Endoscopic biopsy£350
Muscle Biopsy £200
Ultrasound £100
Skin biopsy £50
X-ray (complex) £25
Full biochemistry profile £20
Full microbiology profile £15
Pregnancy test £7.50
Glucose test £5

Will consumer genomics make NGS even cheaper: If people respond to genomics and ask for it from their healthcare providers then costs could fall. A multiplex PCR that amplifies several cancer genes could be very cheap to run if the numbers are high and restricted to genes with relatively simple interpretations.

Can we do cancer NGS testing for as little as a pregnancy test?

PS: the costs of these tests come from a variety of sources but all are likely to suffer the same problem of how those costs were derived. Hopefully this is more Bramleys to Cox's rather than apples to oranges.

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