American Association for Clinical Chemistry
Better health through laboratory medicine
November 2009 Clinical Laboratory News: Diagnostic Tests Remain Undervalued

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November 2009: Volume 35, Number 11

Diagnostic Tests Remain Undervalued

With strong opinions on both sides about whether healthcare reform will reduce costs, a new report prepared by the Lewin Group underscores why diagnostic screening tests are essential to reducing costs in the U.S healthcare system. Commissioned by the American Clinical Laboratory Association and the Advanced Medical Technology Association, the report describes how specific screening tests provide opportunities for cost savings, as well as improved healthcare quality and patient outcomes.

The comprehensive report analyzes four case studies: methicillin-resistant Staphylococcus aureus testing for indentifying healthcare-acquired infections; HbA1c testing for screening diabetes; KRAS gene mutation testing for targeted treatment of colorectal cancer; and human papillomavirus DNA testing for the diagnosis of cervical cancer. These case studies highlight different health problems, risk groups, and testing technologies valuable to many aspects of patient care. Overall, testing programs for these conditions have resulted in better health outcomes for patients while providing cost savings and efficiencies to the healthcare system, according to the report.

Contribution of Selected Diagnostic Tests to Avoidable Costs


Diagnostic Test

Avoidable Costs


HbA1c level

$573 million

Colorectal cancer

Fecal occult blood test

$191 million

Heart disease

Cholesterol test

$87 million

Source: The Lewin Group. The value of diagnostics, innovation, adoption and diffusion into health care. July 2005.

However, the report also stresses that several barriers currently limit the full benefits of laboratory testing from being realized. Examples include: healthcare providers’ ignorance of when to use tests; insufficient evidence regarding clinical utility of tests for specific subgroups of patients; inconsistencies in clinical practice guidelines; conflicting or inadequate coverage and payment policies; and the need for additional evidence to determine the full economic impact of laboratory testing.

The Lewin Group, a health care research and consulting firm, provides analyses to public agencies, nonprofit organizations, industry associations, and private companies, has previously conducted analyses of the value of lab testing. The firm is based in Falls Church, Va., and is an Ingenix company, a wholly-owned subsidiary of UnitedHealth Group.

A full copy of the report is available online.