The Health Economic Impact of Skin Biopsy Detection of Phosphorylated Alpha-synuclein in a Private Practice
Christopher Gibbons1, Colin Gibbons2, Roy Freeman3, Nicole Murray4, Alexandria Swanson4, Jason Crowell5, Justin Phillips5, Sarrah Marcotte4, Jourdan Parent4, manuel Duval4, Todd Levine6
1Beth Israel Deaconess Medical Center, 2Economics, Wesleyan University, 3Beth Israel Deaconess Hosp, 4CND Life Sciences, 5Norton Neuroscience Institute, 6Honor Health
Objective:
To evaluate the health economic impact of skin biopsy detection of phosphorylated alpha-synuclein (P-SYN) in patients with suspected synucleinopathies.
Background:
Skin biopsy detection of P-SYN is a new biomarker supporting the diagnosis of patients with suspected synucleinopathies. However, the economic impact of skin biopsy detection of P-SYN in clinical care has not been explored.
Design/Methods:
A retrospective chart review was completed on 100 patients with suspected synucleinopathy that completed P-SYN testing in a private practice between January 2022 and December 2024. Extracted data included the number of neurologic diagnostic procedures, tests, treatments, and referrals before and after P-SYN testing. Average costs in Louisville, KY, were used to determine the total financial burden (mdsave.com). The final estimated costs were normalized on an annual basis (at 2025 pricing) to account for differences in duration of treatment and follow-up.
Results:
50 males and 50 females (73±8 years) were included in this study. Length of evaluation before P-SYN testing was 26.1±10.3 months, and length of follow-up after P-SYN testing was 14.6±6.8 months. A total of 599 tests were ordered for the cohort, with 69% (413/599) ordered before the Syn-One test. Significant reductions in all tests were noted after Syn-One testing (P<0.01, all groups). Before P-SYN testing, 89 MRIs and 20 DaTscans were completed; In comparison, after P-SYN testing 23 MRIs and 6 DaTscans were completed. Neurological health care costs for the cohort was $587,000. The cohort spent $172,000 more before the cutaneous P-SYN testing. Healthcare expenditure after cutaneous P-SYN testing decreased by $100,521 annually. At a practice level, 135 DaTScan’s were ordered annually prior to introduction of P-SYN testing, and 33 DaTScan’s were ordered annually after introduction of P-SYN testing.
Conclusions:
The economic burden for suspected synucleinopathies for neurological care is significantly reduced after cutaneous P-SYN testing. Reductions in neuroimaging, laboratory studies, and physician referrals drove cost savings.
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