Overbundled tests are a problem in laboratory medicine. Overbundled tests are test panels that contain multiple test components, some of which are unnecessary, or unnecessary at that particular time. Some clinicians like the idea of convenience and large test panels offer "one stop shopping." They can get multiple tests by placing one order and get the added comfort of knowing that "if there is another test that could help with the diagnosis, then I'll probably be getting that one too."
Obviously, there are useful and efficient panels that we are all familiar with (eg, basic metabolic panels, drug screen panels, and liver function panels), but in the reference lab arena, there are many panels that are constructed to provide more information than is often needed, and these come with very high price tags. These types of panels are referred to as overbundled tests. The cost of these large panels is typically, or ultimately, born by the patient. More and more patients have insurance plans with very high deductibles. Thus, many patients will pay for expensive laboratory tests and panels out-of-pocket, before their insurance benefit kicks in. Only ordering laboratory tests that are needed can save the patient and the institution money.
