Diagnostic Testing Approaches for Activated Protein C Resistance and Factor V Leiden: A Comparison of Institutional and National Provider Practices.

Abstract:

Objectives:To analyze the economic impact of testing for activated protein C resistance (APC-R) due to factor V Leiden (FVL) mutation with APC-R with reflexive FVL genotyping (algorithmic approach) or genotyping alone. Methods:OptumLabs Data Warehouse (OLDW) data were used to assess testing approaches. Insurance claims for APC-R and FVL in 2013 were compared with the Mayo Clinic database. Centers for Medicare & Medicaid Services diagnostic fee schedules were used to assign costs. Results:Of 19.3 million OLDW-covered individuals, 74,242 (0.385%) received 75,608 tests: APC-R, 2,265 (2.9%); FVL genotyping, 70,619 (90.1%); and both APC-R and FVL, 2,724 (7.0%). In total, 1,317 tests were performed at Mayo Clinic: APC-R with reflex FVL (1,256; 95.4%) and FVL alone (61; 4.6%). Costs per evaluated individual and per total population (person/year) in OLDW and algorithmic approach were $83.77 vs $36.38 and $0.32 vs $0.14, respectively. Conclusions:The cost-optimized algorithmic approach reduces health care costs.

journal_name

Am J Clin Pathol

authors

Perez Botero J,Majerus JA,Strege AK,Johnson RD,Chen D,Pruthi RK

doi

10.1093/ajcp/aqx033

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

604-610

issue

6

eissn

0002-9173

issn

1943-7722

pii

3784502

journal_volume

147

pub_type

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