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. 2018 Jan 8;3(1):1-9.
doi: 10.1080/23808993.2018.1421858. eCollection 2018.

The economic case for precision medicine

Sean P Gavan  1 , Alexander J Thompson  1 , Katherine Payne  1
Affiliations

The economic case for precision medicine

Sean P Gavan et al. Expert Rev Precis Med Drug Dev. .

Abstract

Introduction: The advancement of precision medicine into routine clinical practice has been highlighted as an agenda for national and international health care policy. A principle barrier to this advancement is in meeting requirements of the payer or reimbursement agency for health care. This special report aims to explain the economic case for precision medicine, by accounting for the explicit objectives defined by decision-makers responsible for the allocation of limited health care resources. Areas covered: The framework of cost-effectiveness analysis, a method of economic evaluation, is used to describe how precision medicine can, in theory, exploit identifiable patient-level heterogeneity to improve population health outcomes and the relative cost-effectiveness of health care. Four case studies are used to illustrate potential challenges when demonstrating the economic case for a precision medicine in practice. Expert commentary: The economic case for a precision medicine should be considered at an early stage during its research and development phase. Clinical and economic evidence can be generated iteratively and should be in alignment with the objectives and requirements of decision-makers. Programmes of further research, to demonstrate the economic case of a precision medicine, can be prioritized by the extent that they reduce the uncertainty expressed by decision-makers.

Keywords: Cost-effectiveness; diagnostic test; economic evaluation; heterogeneity; personalized medicine; precision medicine; stratified medicine; uncertainty.

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Figures

Figure 1.
Figure 1.
Three incremental outcomes consistent with a positive net benefit. The cost-effectiveness plane [43] illustrates the incremental costs (Y-axis) and incremental consequences (X-axis) between a new health technology (for example, a precision medicine) and a relevant comparator (for example, current practice). The dashed line through the origin of the plane represents the cost-effectiveness threshold. Incremental outcomes that are below the dashed line graphically have a positive incremental net health benefit (see accompanying table). The figure illustrates that different combinations of incremental outcomes are possible for a precision medicine to be a relatively cost-effective use of health care resources.
See this image and copyright information in PMC

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