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Decision thresholds with genetic testing

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  • Stefan Felder

    (University of Basel)

Abstract

A genetic test is a test for the presence or absence of a genetic mutation. A positive test outcome that reveals a mutation associated with increased risk for a disease may lead a patient to seek preventive treatment provided that the penetrance (probability of developing the disease given the mutation) is sufficiently high. We derive the test threshold and the test-treatment threshold, which confine the mutation probability interval for the use of the genetic test. Test and treatment costs as well as a low penetrance rate of the mutation narrow this interval. We illustrate the model with parameters of the test for BRCA1 and BRCA2 genes as well as of preventive treatment options for breast cancer.

Suggested Citation

  • Stefan Felder, 2022. "Decision thresholds with genetic testing," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(6), pages 1071-1078, August.
    • Handle: RePEc:spr:eujhec:v:23:y:2022:i:6:d:10.1007_s10198-021-01410-0
    DOI: 10.1007/s10198-021-01410-0
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    References listed on IDEAS

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    1. Christophe Courbage & Béatrice Rey, 2016. "Decision Thresholds and Changes in Risk for Preventive Treatment," Post-Print halshs-01250983, HAL.
    2. Attema, Arthur E. & Brouwer, Werner B.F. & l’Haridon, Olivier, 2013. "Prospect theory in the health domain: A quantitative assessment," Journal of Health Economics, Elsevier, vol. 32(6), pages 1057-1065.
    3. Arthur E. Attema & Werner B.F. Brouwer & Olivier l'Haridon, 2013. "A quantification of prospect theory in the health domain," Economics Working Paper Archive (University of Rennes & University of Caen) 201321, Center for Research in Economics and Management (CREM), University of Rennes, University of Caen and CNRS.
    4. Berger, Loïc & Bleichrodt, Han & Eeckhoudt, Louis, 2013. "Treatment decisions under ambiguity," Journal of Health Economics, Elsevier, vol. 32(3), pages 559-569.
    5. Bardey, David & De Donder, Philippe, 2013. "Genetic testing with primary prevention and moral hazard," Journal of Health Economics, Elsevier, vol. 32(5), pages 768-779.
    6. Francesca Barigozzi & Dominique Henriet, 2011. "Genetic Information: Comparing Alternative Regulatory Approaches When Prevention Matters," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 13(1), pages 23-46, February.
    7. Peter P. Wakker, 2008. "Lessons Learned by (from?) an Economist Working in Medical Decision Making," Medical Decision Making, , vol. 28(5), pages 690-698, September.
    8. Peter Wakker & Anne Stiggelbout, 1995. "Explaining Distortions in Utility Elicitation through the Rank-dependent Model for Risky Choices," Medical Decision Making, , vol. 15(2), pages 180-186, June.
    9. Felder, Stefan, 2020. "The treatment decision under uncertainty: The effects of health, wealth and the probability of death," Journal of Health Economics, Elsevier, vol. 69(C).
    10. Christophe Courbage & Béatrice Rey, 2016. "Decision Thresholds and Changes in Risk for Preventive Treatment," Health Economics, John Wiley & Sons, Ltd., vol. 25(1), pages 111-124, January.
    11. Michael Hoy & Richard Peter & Andreas Richter, 2014. "Take-up for genetic tests and ambiguity," Journal of Risk and Uncertainty, Springer, vol. 48(2), pages 111-133, April.
    12. Diego C. Nocetti, 2018. "Ambiguity and the value of information revisited," The Geneva Papers on Risk and Insurance Theory, Springer;International Association for the Study of Insurance Economics (The Geneva Association), vol. 43(1), pages 25-38, May.
    13. Bleichrodt, Han, 2001. "Probability Weighting in Choice under Risk: An Empirical Test," Journal of Risk and Uncertainty, Springer, vol. 23(2), pages 185-198, September.
    14. David Crainich, 2017. "Self-Insurance With Genetic Testing Tools," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 84(1), pages 73-94, March.
    15. Chris Starmer, 2000. "Developments in Non-expected Utility Theory: The Hunt for a Descriptive Theory of Choice under Risk," Journal of Economic Literature, American Economic Association, vol. 38(2), pages 332-382, June.
    16. Michael Hoy & Julia Witt, 2007. "Welfare Effects of Banning Genetic Information in the Life Insurance Market: The Case of BRCA1/2 Genes," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 74(3), pages 523-546, September.
    17. Peter, Richard & Richter, Andreas & Thistle, Paul, 2017. "Endogenous information, adverse selection, and prevention: Implications for genetic testing policy," Journal of Health Economics, Elsevier, vol. 55(C), pages 95-107.
    18. Russell Golman & David Hagmann & George Loewenstein, 2017. "Information Avoidance," Journal of Economic Literature, American Economic Association, vol. 55(1), pages 96-135, March.
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    Cited by:

    1. De Donder, Philippe & Bardey, David & Zaporozhets, Vera, 2024. "The Health Technology Assessment Approach of the Economic Value of Diagnostic Tests - A Literature Review," TSE Working Papers 24-1508, Toulouse School of Economics (TSE).

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    More about this item

    Keywords

    Diagnostic risk; Decision thresholds; Genetic risks; ICER;
    All these keywords.

    JEL classification:

    • D81 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Criteria for Decision-Making under Risk and Uncertainty
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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