The new genetics: will it pay its way?

The number of genetic disorders detectable antenatally by the use of DNA probes has risen rapidly. The demand for diagnosis and termination of affected pregnancies in high-risk families is likely to increase as tests become more accurate and widely known. Each Regional Health Authority (RHA) must therefore urgently compare any financial savings to be made from a DNA diagnostic service with the cost of setting up and running a laboratory. There are great difficulties in conducting a formal cost-benefit analysis, but the pressing need for a cost appraisal made a more limited cost-savings approach necessary. This paper uses a broad-brush approach for all disorders and known costs for inpatient hospital care only. Despite the limitations of the method, in the two regions studied (North West and South East Thames) there would be clear savings at hospital level if a DNA screening laboratory were set up in each region. Funds released from treatment of genetic disorders could be used for other purposes. There are benefits to the families concerned, social service and educational savings, and other health service savings not considered here. On hospital costs alone there are benefits from the programme and wider consideration will make it more cost-effective. Once a programme is set up, new developments will make it even more cost-effective. It is concluded that RHAs should attach high priority to the setting up of such laboratories.