GeneMatters

Part
01
of one
Part
01

Genetic Counseling Market: TAM

There is no direct calculable amount in addressing the market size or TAM of the genetic counseling market in the United States. This is due to a myriad of reasons including the variance in official titles and positions of genetics counselors; but mainly due to how intertwined genetic testing is with genetic counseling resulting in a wide range of possible costs per session. In addition, approximately 65% of genetic counselors provide direct patient care, while the remainder primarily work in clinical settings, thus the billables for these two segments are indiscernible. The best estimate for the TAM of the United States genetic counseling market is $655.6 million. Three possible methods of calculating the TAM for the market are detailed below.

Determination of the Market

  • Genetic counselors primarily function in one of two industry segments: direct patient care and clinical settings. Only about 65% of certified genetic counselors provide direct patient care.
  • These types of counselors (GCs) are trending towards serving a wide variety of roles and positions across the healthcare spectrum, "including test utilization management for a variety of stakeholders involved in genetic testing processes, including patients, ordering institutions, testing laboratories, and payers; in settings as diverse as a hospital or clinic, laboratory, community health center, government entity, and insurance company."
  • The types of services a genetic counselor may offer or be involved in varies widely. They might search "through a patient's family tree to highlight any potential health risks", such as "a person with a family history of cancer might meet with a genetic counselor to determine his or her risk for receiving similar diagnoses. If a patient decides to move forward with a genetic test, the counselor then coordinates laboratory work — usually a blood test — for a clearer picture of any genetic risks. Next comes the interpretation, where the counselor examines test results to look for any mutations that might explain a current disorder or syndrome, or that might predict future ones. The counselor then sits with the patient and his or her family to explain the findings and their ramifications. If necessary, genetic counselors also discuss the ways in which the information might be used in a patient's medical care."
  • In addition, "technological advances have also boosted the type of testing genetic counselors may administer and interpret."
  • Carrie Blount, a genetic counselor at Brigham and Women’s Hospital in Boston, states, "the average cost of (genetic counseling) services to patients can vary greatly, based on insurance reimbursement rates. On average, genetic counseling is often not lucrative for hospitals. "
  • Colleen Caleshu, lead genetic counselor for the Stanford Center for Inherited Cardiovascular Disease at Stanford Health Care, stated, "most private insurers reimburse, but hospitals still can’t bill Medicare for genetic counseling services, despite it being a benefit covered under Medicare. Currently, a patient’s supervising physician can be reimbursed for genetic counseling provided by a professional counselor as an “incident to” the physician visit. Genetic counselors then can charge a “facility fee” but cannot bill for their professional services.
  • “Reimbursement really has stayed relatively poor,” said St. Joseph’s Brown. “There has been low or no reimbursement for genetic counseling services for quite some time.”

Potential Counseling Patients & the Price Per Patient

  • Since genetic counselors assist patients with a variety of disorders and some patients who use genetic counselor services are not afflicted with a particular disease, calculating the TAM using the number of patients or potential patients is not feasible. The only reasonable number of people available for this calculation method is the total number of adults in the United States, 255,369,678.
  • For example, many different types of hereditary diseases or conditions can be identified using genetic testing, thus requiring genetic counseling. Breast cancer, high cholesterol, Cystic Fibrosis and depression are four examples of many.
  • "In August 2019, the All of Us Research Program announced the funding of a nationwide resource to provide genetic counseling support to one or more million participants."
  • "Eventually, the success of All of Us could accelerate the demand of genetic counseling, from 1 million to 300 million people, making genetic counseling an important public health tool to help target health communication and education messages for the general population."

Number of Genetic Counselors & Average Salary

  • "There are currently only 4,818 certified genetic counselors in the US, while about 26 million consumers have used DTC genetic testing. Most clinics prioritize patients who have a clear indication for genetics services, for example, because of a strong family or personal history of a disorder, suspicious signs and symptoms, or abnormal genetic test results."
  • The median earnings for a genetic counselor, according to the US Bureau of Labor Statistics was $80,860, as of May 2018.

Genetic Counselors & Workload of Pateints Per Month

  • "According to the 2016 NSGC PSS, the mean caseload of a patient-facing certified genetic counselor was approximately 36 patient visits per month."
  • "For patients not covered by health insurance genetic testing typically costs $150 or more per hour. The length of the consultation depends on the severity of the condition and how much research is required."
  • The time of a counseling session can be estimated at 125 min for individualized care.

Research Strategy and Calculations

Three possible methods of calculating the TAM of the genetics counseling market include multiplying the addressable population times the cost per patient. The best estimation available for this method is the total population of adults in the United States times the cost of counseling services. Since sources such as the National Center for Biotechnology Information of the U.S. National Library of Medicine state there is a very wide range of cost directly associated with counseling services, the estimated TAM ranges widely. In addition, there is no definitive source available to calculate the potential population cohort by defining the target market. Thus, no discernible TAM is practical using this method.

However, by employing the second possible method, multiplying the total number of certified genetics counselors times their average annual salary, an estimated TAM for the market would be the number of certified genetic counselors in the US, 4818, times their average salary, $80,860. This equals over $389.6 million per annum. It is logical to assume this would better apply to the current market size since it is the sum of current estimated costs to the industry of certified genetic counselors, the outflow cost. Caution is needed with this estimate as it excludes non-certified genetic counselors and includes all the fields of certified counselors, not just those that provide direct patient services.

The third method in estimating the TAM for the genetic counseling market involves utilizing the quantity of counselors times their average workload times the estimated cost or price per patient session. Thus, the number of counselors, 4818, times their workload, 36 patient visits per month, time the hourly rate, $150, times the average length of time per visit, 2.1 hours, or 4818 x 36 x 12 x $150 x 2.1. The result is a TAM of just more than $655.6 million in the US. Since there are discrepancies among hourly rate charges and actual charges for reimbursement are not published, the $150 is just an estimate. The actual total may range a bit higher, possibly up to 25% more.


Sources
Sources