Genetic Health Economy[Экономика Генетического Здравоохранения]

The article provides an overview of the social and economic effects of restructuring healthcare on the basis of regular use of genetic data. The review covers such problems as medical efficiency of the proposed model, its affordability and economic efficiency (micro and macro levels), and external (technical, behavioral, ethical, and legal) constraints. Empirical studies indicate low medical and economic efficiency of universal coverage of whole genome sequencing. For most diseases, genome analysis does not allow one to take adequate measures to prevent risk of suffering from it given the lack of information about its genetic nature, the limited role of genetic factors in onset and progression of diseases and the absence of effective low risk management practices. The combination of rarity of significant genetic variants and low efficiency of early prevention leads to worse efficiency of universal genetic screening compared with traditional preventive measures. Promising directions for genome medical technologies in the short and medium term are diagnosis of hereditary diseases and strong predisposition to certain diseases as well as drug therapy personalization. The rate of adoption of new technologies in regular clinical practice will be determined by the willingness of the state and private entities to invest in the required infrastructure, including creating national banks for genetic data, acquiring equipment for analysis and storing the data obtained, and training of qualified personnel. At the moment Russia has a backlog of several years in this area compared with advanced countries. The national program for the development of genetic technologies, capable of closing the gap, is expected to be approved in early 2019.