The Economic Costs of Genetic Counseling: A Combined Expert Perspective and Systematic Review.

Abstract

Purpose: Genetic counseling (GC) is integral to personalized medicine, yet detailed estimates of its cost remain limited despite growing demand. This study systematically reviewed and synthesized evidence on GC costs, examined variations across settings, methodologies, and reported cost components.

Methods: A systematic literature review was conducted following PRISMA guidelines across Embase and Ovid Medline databases. Studies were included if they reported GC costs. Data were extracted on study characteristics, methodologies, and reported costs. Costs were adjusted to 2024 values using OECD Consumer Price Index and converted to USD for comparability. A narrative synthesis approach was adopted due to methodological heterogeneity.

Results: Nineteen of 1,487 screened studies met the inclusion criteria. Most relied on wage-based and time-based costing approaches, with limited use of systematic microcosting. Inflation-adjusted GC costs ranged widely ($72 to $1,970). Studies capturing only direct patient contact consistently reported lower costs than those incorporating indirect activities.

Conclusion: Published GC costs vary markedly due to differences in costing scope, methodology, and healthcare systems. Standardized costing frameworks are needed to improve comparability across studies and support accurate planning, resource allocation, service design, and evaluation in genomic medicine.