Background: The global economic burden of treating genetically distinct conditions is growing rapidly. An interest in prophylactic treatment and pharmacogenetic decision-making has emerged in concert with an increasing usage of genetic tools, such as prenatal genetic testing, biomarker assays, and personal genomic tests, to presymptomatically identify these conditions. However, little is known about the optimal timing of these approaches to best impact patient care and, where applicable, to consider the cost of care in providing prophylactic treatment.
Purpose: To determine the optimal developmental timepoint in early childhood to screen for certain health conditions presymptomatically and measure the financial impact of the resulting clinical actions.
Methods: A retrospective review of vaccination compliance, as a proxy for health care utilization, of the 3,969,953 eligible individuals from 2012 through 2018 using de-identified data from the Wisconsin Immunization Registry. Further analysis across racial groups was assessed, and the financial impact of changes in cost of care. Concurrently, a parental survey was conducted to determine preference for the timing and disease inclusions of genetic tests.
Results: Overall vaccination rates revealed maximal compliance during the first 6 months of visits, with the highest compliance rate at month 4 (71.2%). However, this rate significantly differed when racial groups were assessed independently, with compliance in Caucasian children highest at 4 months (80.0%) and all other racial backgrounds highest at 2 months (66.3%–72.6%).
Conclusion: Results demonstrated that health care utilization is greatest within the first 4 months after birth, suggesting an optimal time to administer tests designed to detect health conditions presymptomatically
