Multiomic DNA Test for Heart Disease May Save Health Insurers Millions

Summary: Cardio Diagnostics released findings from a budget impact modeling study on its AI-powered multiomic DNA test designed for detecting stable coronary heart disease, which presented its ability to save up to $113.6 million annually for a health plan with one million members.

Takeaways:

1. The use of the PrecisionCHD test for initial coronary heart disease assessment can lead to substantial cost reductions for healthcare providers and insurers, with potential savings of $113.6 million per year for a health plan serving one million members.
2. PrecisionCHD utilizes a combination of six DNA methylation and ten genetic biomarkers analyzed through a proprietary machine learning model. It has shown a sensitivity of 79% and specificity of 76%, indicating its effectiveness in accurately detecting stable CHD.
3. The test has received a Current Procedural Terminology (CPT) code from the American Medical Association and an Innovation Technology contract from Vizient.

Cardio Diagnostics Holdings, a provider of next-generation precision cardiovascular medicine technologies utilizing AI algorithms with epigenetic and genetic biomarkers, announced the publication of results from a budget impact modeling study for PrecisionCHD, the company’s AI-powered multiomic coronary heart disease detection test. 

The peer-reviewed study “The Use of Precision Epigenetic Methods for the Diagnosis and Care of Stable Coronary Heart Disease Reduces Healthcare Costs” published in Advances in Therapy, reported that the use of PrecisionCHD can significantly reduce the cost of secondary prevention for stable coronary heart disease (CHD) by up to $113.6 million per year for a typical health insurance plan with one million members, the company says.

AI-Powered DNA Test for Coronary Heart Disease

PrecisionCHD is an AI-powered multiomic DNA test using epigenetic and genetic biomarkers to aid in the detection of stable coronary heart disease. This blood-based test evaluates six DNA methylation and ten genetic biomarkers and uses a proprietary machine learning model to interpret the genetically contextual methylation signals from these biomarkers. The sensitivity and specificity of this test are 79% and 76%, respectively, with the clinical validation study in collaboration with Intermountain Healthcare and University of Iowa Hospitals and Clinics being recently published in the Journal of American Heart Association.

Cost Savings for Coronary Heart Disease Testing

The PrecisionCHD budget impact model was designed to evaluate the cost savings associated with using PrecisionCHD as the primary method of initial coronary heart disease assessment in place of current commonly used tests such as exercise electrocardiograms, coronary computed tomography angiography (CCTA), and angiograms. The model considered factors such as the number of tests performed, the cost of each test, and the impact of test results on treatment decisions. The results suggest that using PrecisionCHD could lead to significant cost savings for payers, with an estimated $113.6 million saved per year for a plan with one million members. These savings are primarily driven by the lower cost of PrecisionCHD compared to traditional tests and the reduced need for additional testing. The model also found that the cost savings were not sensitive to patient demographics, or insurance plan design, with similar results being observed for plans that exclude Medicare enrollees, only include Medicare enrollees (Part B or Medicare Advantage), offer large co-insurance rates, and offer larger co-pays, according to the company.

“The data from this study suggests that the broader use of PrecisionCHD as the initial test for detecting coronary heart disease can yield significant savings to payers,” says David Frisvold, PhD, associate professor in the Department of Economics at the University of Iowa and lead author of this study. “More importantly, the reported cost savings were shown to be generalizable to various health plans, potentially leading to increased access to care and improved outcomes for patients with CHD.”

PrecisionCHD was recently awarded the Current Procedural Terminology (CPT) Proprietary Laboratory Analyses (PLA) code, 0449U, by the American Medical Association that went effective on April 1, 2024. PrecisionCHD was also awarded the Innovation Technology contract from Vizient, the nation’s largest group purchasing organization, whose customer base encompasses over 60% of hospitals and 97% of academic medical centers in the United States.