Saturday, September 17, 2022

The Rapid Expansion of DTC Healthcare

Preventive care is recognized as the most effective strategy for health care cost reductionScreening for early signs of heart disease, cancer, maintenance of diabetes and allergies and prevention of infectious diseases can be done without a supervising physician. Direct-to-consumer (DTC) laboratory testing allows individuals to order tests directly from a laboratory without going through their healthcare provider, and often at lower costThe number of companies providing direct-to-consumer diagnostic testing is rapidly growing, along with the range of health information provided by these tests. Ancestry (genealogy) testing is an example. And so are new devices for cardiac monitoring

Experts anticipate a near-term explosion in the DTC marketplace. DTC healthcare already was a US$700 billion industry in 2020, including over-the-counter drugs. The Mark Cuban Cost Plus Drug Company, PBC (MCCPDC) is nearing one million customers. An analysis of 2011-1019 records from Rock Health Digital Database, showed that 252 (21%) of 1214 digital health companies pursued a direct-to-consumer strategy. The pandemic has accelerated this growth. According to research by Deloitte, the number of people using virtual healthcare rose from 15% to 19% from 2019 to early 2020, then jumped to 28% in April 2020. On average, 80% were likely to have another virtual visit, even post COVID-19 and said they will use this type of care again. Latest data showed that consumers’ appetite for virtual health and digital health tools continued to steadily increased, although there was significant variation in physician adoption. 

Human touch remains central to care delivery. In the 2022 Deloitte Survey of US Health Care Consumers, 70% of respondents who had a virtual visit in 2022 (vs. 67% in 2020) thought that the quality of virtual care was as good as in person, but only 73% (vs. 82% in 2020) thought they were able to connect with the clinician the same way they would in-person. Integration of data from patients' wearables and their self-reported outcomes into health records also experienced a setback

The global market for Direct-to-Consumer (DTC) testing was predicted to grow from $1.4 billion in 2020 to $2.6 billion by 2025. There were cautionary cases of uBiome and Theranos, there are quackery labs, but as the industry matures and moves toward utilization of clear clinical metrics, and as the capabilities of technology advance, DTC testing will me more and more impactful. There are DTC companies that offer the tests and biometric screenings that a physician would typically order as part of a routine annual physical, such as a complete blood count, comprehensive metabolic panel, urinalysis, and cardiovascular and diabetes risk assessment. Ultalabs, JasonHealth, discounted labs, drsays and privatemdlabs all allow to self-order laboratory tests and Quest and Labcorps locations. 
No more uncomfortable questions for a blood test prescription. No doctor visit needed to gettest results - they will be emailed instead. Consumers pay up front and know exactly what they are paying for. Unfortunately, the same cannot be said for many other healthcare services.

Genetic counseling for patients who are pursuing genetic testing in the absence of a medical indication, referred to as elective genomic testing (EGT), is becoming relatively common. More people are using technology to monitor their health, measure fitness, and order prescription refills. Before COVID-19, there was a slight decline in people who were willing to share their health data—but during the pandemic, new data showed that people are more comfortable sharing data during a crisis


Cohen AB, Mathews SC, Dorsey ER, Bates DW, Safavi K. Direct-to-consumer digital health. The Lancet Digital Health. 2020 Apr 1;2(4):e163-5.

Stoffel M, Greene DN, Beal SG, Foley P, Killeen AA, Shafi H, Terrazas E. Direct-to-Consumer Testing for Routine Purposes. Clinical Chemistry. 2022 Sep;68(9):1121-7.

2022 Global health care sector outlook | Deloitte


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