Economic Evaluation of GARDE: A Digital Health Platform for Population-Level Hereditary Cancer Risk Assessment

Area of Science:

• Genetics and Genomics
• Health Informatics
• Oncology

Background:

• Over 90% of individuals with hereditary cancer syndromes in the US remain undiagnosed.
• Genetic cancer risk assessment and testing are crucial for early detection and prevention.
• Current systems often fail to identify at-risk populations effectively.

Purpose of the Study:

• To evaluate the budget impact of the Genetic Cancer Risk Detector (GARDE) platform on healthcare institutions.
• To assess the economic viability of an EHR-integrated digital health tool for genetic cancer risk assessment.
• To determine the return on investment for implementing GARDE in a clinical setting.

Main Methods:

• A 3-year budget impact analysis was conducted from a US healthcare provider system's perspective.
• Data from the BRIDGE randomized controlled trial at University of Utah Health (UHealth) were utilized.
• Costs included GARDE planning, implementation, and operations; revenue was projected based on CMS reimbursement rates.

Main Results:

• The 3-year implementation cost was $29,217 USD, generating $86,563 USD in revenue, resulting in a net positive budget impact of $57,347 USD.
• Genetic testing identified pathogenic variants in 15 out of 205 patients.
• Risk-reducing surgeries were the primary revenue driver (76.4%); scaling implementation increased revenue significantly.

Conclusions:

• The GARDE platform facilitates scalable hereditary cancer risk assessment and yields a positive financial return.
• Wider implementation of GARDE can substantially increase revenue and improve precision cancer prevention.
• EHR-integrated tools like GARDE are economically viable for enhancing clinical outcomes in cancer risk management.