1. ¹Centre for the Economics of Health, Institute of Medical and Social Care Research, Wheldon Building, University of Wales, Bangor LL57 2UW, UK
2. ²Institute of Medical Genetics, Cardiff and Vale NHS Trust, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK
3. ³North Wales Section, Department of General Practice, University of Wales College of Medicine, Wrexham Technology Park, Wrexham LL13 7YP, UK
4. ⁴Department of Psychology, University of Wales, Swansea, Singleton Park, Swansea SA2 8PP, UK

Correspondence: GL Griffith, E-mail: g.griffith@bangor.ac.uk

Received 20 July 2004; Revised 12 October 2004; Accepted 19 October 2004; Published online 7 December 2004.

Abstract

This paper presents the first full micro costing of a commonly used cancer genetic counselling and testing protocol used in the UK. Costs were estimated for the Cardiff clinic of the Cancer Genetics Service in Wales by issuing a questionnaire to all staff, conducting an audit of clinic rooms and equipment and obtaining gross unit costs from the finance department. A total of 22 distinct event pathways were identified for patients at risk of developing breast, ovarian, breast and ovarian or colorectal cancer. The mean cost per patient were £97–£151 for patients at moderate risk, £975–£3072 for patients at high risk of developing colorectal cancer and £675–£2909 for patients at high risk of developing breast or ovarian cancer. The most expensive element of cancer genetic services was labour. Labour costs were dependent upon the amount of labour, staff grade, number of counsellors used and the proportion of staff time devoted to indirect patient contact. With the growing demand for cancer genetic services and the growing number of national and regional cancer genetic centers, there is a need for the different protocols being used to be thoroughly evaluated in terms of costs and outcomes.