Estimating the cost of genomic diagnostic technologies using micro-costing: A Tutorial

Estimates of costs of healthcare technologies and services are required to inform decision and policy making. Genomic testing consists of multiple steps and involves a range of products and services as part of the overall process. These underlying technologies can be sensitive to the platforms utilized, resource type, prices, and technological maturity. Detailed costing methods such as micro-costing, are useful to disaggregate individual cost components and evaluate variations across different settings. Existing resources on estimating the costs of disease states and explanations of micro-costing are available in the literature, however, detailed guidance on conducting micro-costing remain unpublished. In this study, we present a step-by-step guide to undertaking genomics micro-costings. We focus on the practical aspects of micro-costing, from conceptualizing the research question to estimating disaggregated costs for a particular technology. We provide a practice example with step-by-step R and Python code illustrating the process of estimating the uncertainty associated with health technology costs and cost drivers.