Medicare wasting $500 million yearly on genetic blood tests with no benefits, study finds

Researchers said that testing for venous thromboembolisms can be both an unnecessary expense and in some cases harmful to patients. 
By Jack McCarthy
09:50 AM

Medicare is spending about $500 million a year on genetic blood tests that offer little or no clinical benefit and may be unnecessary, according to a study in the Journal of Hospital Medicine.

The report, by a University of Michigan Medical School team, examines testing for a trait called inherited thrombophilia, and calls for a drastic cut in the test’s use by doctors.

The team said patients who have already had such dangerous clots, called venous thromboembolisms or VTEs, don’t need to register a positive genetic test to justify taking medication and making other changes to prevent future ones.

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Furthermore, there’s no evidence that medication to prevent clots will help hospital patients who haven’t yet had a VTE. Testing their DNA for inherited thrombophilia won’t change that.  

As a result, there is little justification for ordering inherited thromboembolism testing on inpatients, which doctors now do hundreds of thousands of times a year in Medicare patients alone.

“More testing is not always better,” Christopher Petrilli, MD, an assistant professor of internal medicine at the University of Michigan and co-author of the new paper, said in a statement.

“Testing for this disorder is almost never beneficial, and in fact can even be harmful because it can cause undue psychological distress for the patient, and unnecessary expense for the healthcare system,” Petrilli added.

Petrilli and other clinicians at the U-M Health System’s University Hospital co-founded a local chapter of the group Providers for Responsible Ordering, to help physicians, nurse practitioners and physician assistants reduce over-testing and use health care resources appropriately.

They are also helping UMHS participate as one of more than 40 founding members of the High Value Practice Academic Research Alliance, which is working to bring institutions together to implement strategies that make better use of resources.

“With national health care spending reaching an unsustainable level, we as physicians need to be vigilant about becoming stewards of healthcare resources,” said Laurent Heidemann, MD, another co-author of the study.

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