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23 - Economics of personalized medicine

from Part V - Population genetics and personalized medicine

Published online by Cambridge University Press:  18 December 2015

By
Katherine Payne  and
Martin Eden
Edited by
Krishnarao Appasani
Foreword by
Stephen W. Scherer  and
Peter M. Visscher
Katherine Payne
Affiliation:
The University of Manchester
Martin Eden
Affiliation:
The University of Manchester
Krishnarao Appasani
Affiliation:
GeneExpression Systems, Inc., Massachusetts
Stephen W. Scherer
Affiliation:
University of Toronto
Peter M. Visscher
Affiliation:
University of Queensland
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Summary

Introduction

Use of the term “personalized medicine” is now ubiquitous. However, there is little consistency in how personalized medicine is either defined or used in clinical practice. Various authors have attempted to bring together the different definitions of personalized medicine (for example: Redekop and Mladsi, 2013; Schleidgen et al., 2013). A framework has been put forward, which can be used to understand the implications of personalized medicine in terms of: the questions (e.g., what is the diagnosis?); the methods used to answer them (e.g., a test); and the available actions (e.g., to give or not give a particular drug). Alongside this proposed framework, Redekop and Mladsi offer a useful working definition of personalized medicine as: “the use of combined knowledge (genetic or otherwise) about a person to predict disease susceptibility, disease prognosis, or treatment response and thereby improve that person's health.” This is the definition adopted in this chapter, because it facilitates discussion of the broad implications when considering the economics of personalized medicine, rather than adopting the narrower focus on using genetics to target medicines.

Irrespective of how personalized medicine is defined, decision-makers charged with allocating finite healthcare budgets require robust and timely evidence to support the cost-effectiveness of technologies used to “personalize” the diagnosis, prevention, or treatment of diseases. Information on the value for money of technologies used to personalize medicine is needed before they can be recommended for funding and used in clinical practice. This chapter outlines the underlying concepts that inform the framework of economic evaluation which can be applied to provide decision-makers with the requisite information. The different types of economic evaluation are described and a summary of the current level of evidence supporting the use of a specific type of personalized medicine, using pharmaco-genetic and pharmaco-genomic technologies, is provided. An overview of the key stages in the design and conduct of an economic evaluation is presented. The chapter concludes by presenting an overview of the issues to be considered when evaluating the economic impact of technologies to personalize medicine.

Informing decision making

The existence of finite healthcare budgets and the scarcity of healthcare resources mean that there is an opportunity cost associated with every decision made to provide an intervention. The decision to allocate resources to a particular service excludes those resources from alternative possible uses within a healthcare system.

Type
Chapter
Information
Genome-Wide Association Studies
From Polymorphism to Personalized Medicine
 , pp. 366 - 382
Publisher: Cambridge University Press
Print publication year: 2016

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