Terry Flynn recently blogged on how treatment tailored to genes will kill economic evaluation. It’s a catchy title that I hope will draw health economists working outside of genetics into a growing debate on the best way to do economic evaluation in genetics and genomics. However, I don’t entirely agree with everything that Terry said and wanted to respond on a few points:
Yesterday in Oxford we hosted a conference titled “Personalised Medicine and Resource Allocation”. The conference aimed to explore the challenges of implementing genomic medicine into widespread clinical practice, and there was a particular focus on the generation of economic evidence and the ethical issues that arise in the resource allocation decisions required to allow personalised medicine to be realised.
I was pleased to be asked to speak at the event, and I presented alongside Jilles Fermont on “Methodological issues surrounding the health economic evaluation of genomic technologies and a case study of these issues in the research setting”. It was an interesting day overall, and I suspect that others will blog more extensively on the various topics that were discussed. For now, I’ll leave a link to our slides, in case anybody is interested in this topic. For more information on the day itself, please visit the conference website or follow the proceedings on Twitter via the hashtag #PMRAoxford.
In my first blog post, I posed a number of questions that were relevant in health economics and genomics. One of these was “Is there a greater role for cost-benefit analysis in genomics?”. I’m working towards contributing to this debate with my PhD (if I ever finish), and one of the byproducts of my PhD is this paper, published over the weekend in PharmacoEconomics, titled: “Welfarism Versus Extra-Welfarism: Can the Choice of Economic Evaluation Approach Impact on the Adoption Decisions Recommended by Economic Evaluation Studies?”. I hope it mght be relevant to other health economists working in genomics, so I thought I would share it here. There are (hopefully!) a few findings of note, but I guess the main take-home message is this: “We found that for every five studies applying both approaches, one shows limited or no concordance in economic evaluation results: the different approaches suggest conflicting adoption decisions, and there is no pattern to which approach provides the most convincing adoption evidence”. It certainly provides food for thought when designing economic evaluations in genomics.
Last week I attended the Astellas Innovation Debate (“i-Genes: What the DNA and Data revolutions mean for our health”) at the Royal Institution of Great Britain in London. This was an interesting event and I was pleased to get the opportunity to make a couple of points during the debate itself. I also wrote about the debate and the wider implications of this revolution from a health economics perspective for the BMJ. You can read this blog here.
Interested readers can watch the entire 2015 debate at http://www.innovationdebate.com/.