On the determinants and the role of the payers in the uptake of genetic testing and data sharing in personalized health.

Background: New health technologies and data offer tailored prevention and spot-on treatments, which can considerably reduce healthcare costs. In healthy individuals, insurers can participate in the creation of health capital through data and preventing the occurrence of a disease. In the onset of a disease, sequencing an individual's genome can provide information leading to the use of more efficient treatments. Both improvements are at the core of the "personalized health" paradigm. As a positive side effect, a reduction in healthcare costs is expected. However, the integration of personalized health in insurance schemes starts with a closer understanding of the demand drivers. Methods: Using novel data from a survey carried out in Switzerland, we determine the factors influencing the uptake and sharing of data from genetic tests. In our regression analyses, we use five sets of socioeconomic, lifestyle, health insurance, sentiment, and political beliefs variables. Furthermore, two framings assess the willingness to undertake a test and the readiness to share results with an insurer when the costs of the test are borne by the insurer or the individual. Results: We find that socioeconomic, lifestyle, or political belief variables have very little influence on the uptake of tests and the sharing of data. On the contrary, our results indicate that sentiment and insurance factors play a strong role. More precisely, if genetic tests are perceived as a mean to perform health prevention, this pushes individuals to take them. Furthermore, using the insurer's smartphone app leads to an increase of the likelihood to undergo a test and doubles the probability to share related data. Regarding insurance plans and deductible levels, there is no strong correlation neither with the willingness to take a test nor to share the data. Finally, individuals with complementary health insurance plans are less likely to share results. From the framings for the payment of genetic tests, our results indicate a positive effect of the insurer as a payer on the willingness to undertake tests as well as on data sharing. Conclusion: Our results lay the ground for a deeper understanding of the role of payers on health decisions and sharing of health-related data. In particular, we find that it is relevant for health insurers to engage with their clients.