Valuing personalized medicine: willingness to pay for genetic testing for colorectal cancer risk

Personalized medicine using genetic information is increasing in cancer screening and treatment; however, little is known about perceived value of genetic testing for cancer risk in a general population. The objectives of this report are: to identify a general population's willingness to pay for genetic testing that provids colorectal cancer risk information; examine whether screening intentions (likelihood of testing and test choice) change based on risk; and identify providers' beliefs about patients' perceived value.

A survey of US general (n = 1087) and physician (n = 100) populations using the willingness-to-pay method was carried out. Physicians responded from the perspective of a typical patient. χ² tests, t-tests and ordered logistic regression were used to examine factors associated with willingness to pay and intentions to be screened.

General population respondents' average willingness to pay for a genetic test for colorectal cancer risk was US$150. Higher willingness to pay was significantly associated with being male, having higher income and education, having private health insurance and reporting a greater likelihood of getting colorectal cancer screening when due. Physicians' beliefs about patients were different than general population responses: physicians believed patients would be willing to pay more (US$212; p < 0.001), fewer believed patients would not pay (1 vs 17%; p<0.001), and if a genetic test indicated higher than average risk, physicians believed patients would be more likely to get screened (65 vs 46%; p < 0.001) and would choose alternative screening tests (62 vs 22%; p < 0.001).

Respondents valued genetic tests to inform screening decisions and indicated that tests may influence screening choices. Additional studies are needed to examine the implications of physicians' beliefs about patients' choices for screening.