Utilisation of subsidised genetic and genomic testing in a publicly funded healthcare system 2014-2023.

The Australian government subsidises medical services, including several genetic and genomic tests, through a federal funding scheme. We explore trends and variation in the utilisation of the publicly funded genetic and genomic tests over the last decade. We make use of administrative data of the listed genetic and genomic tests from financial year 2014 to 2023. In 2023, 102 genetic and nine genomic tests were publicly subsidised across 65 distinct clinical test indications, up from 32 items across 20 distinct tests in 2014. Service volumes have increased by 50% from 250,881 to 376,140, and benefits paid have risen by 83% from AU$42.0 million to AU$76.8 million. This accounts for 0.3% of the total AU$27.6 billion expenditure on publicly subsidised medical services in 2023. Somatic cancer, rare disease, and reproductive tests are the most prevalent tests. Women of childbearing ages used more services than men, however in nonchildbearing ages, men used more services than women. The current usage of publicly funded genetic and genomic testing within Australia is relatively modest, underscoring challenges in integration to routine clinical practice. However, the recent rapid expansion of subsidised items indicates that investments into genomics research are beginning to yield the evidence necessary to secure public funding for these services.