I’m currently working on a project which is identifying the key barriers which are slowing down the translation of whole genome sequencing into clinical practice, and as a result I’ve been digging into the literature on priority setting and genomics (on the basis that one barrier might be resource constraints). To be honest, this hasn’t taken a lot of time, as it’s not a particularly well-researched area. That said, there were two specific papers that have informed the development of our work in this area, and I thought it might be interesting to bring these to the attention of a wider audience. Continue reading
Just a quick note to say that a book titled “Genomics and Society; Ethical, Legal-Cultural, and Socioeconomic Implications” was published today (available on Amazon here).
In this book you can find a chapter that I co-wrote with Dr Sarah Wordsworth from HERC and Professor Adrian Towse from the Office of Health Economics titled “Health economic perspectives of genomics”. You can read the chapter via Google Books here, and you may also be able to download a copy here, depending on your institutional access. I hope it is of interest.
So, apologies again for the radio silence. Good news though: the PhD has finally been submitted! That’s not quite the end of that chapter in my life though, as I still have a viva to complete and six more publications to prepare to add to the two that have been published in the last 18 months or so. Hopefully I’ll be able to share more of my PhD outputs from the start of 2016 onwards, depending (of course) on the vagaries of the peer-review process.
Anyway, I now have time to read and then write about all of the publications that I’ve been putting to one side over the last few months. I’m going to start with a paper by Carlos Gallego et al. which was published in JCO in May, and which considered the cost-effectiveness of next generation sequencing (NGS) panels for the diagnosis of colorectal cancer and polyposis (CRCP) syndromes.
Apologies for the recent lack of blog posts. It turns out it takes a lot of effort to get a PhD written up alongside other research commitments. Normal service will be resumed very soon. For now, a few quick notes on the International Health Economics Association meeting in Milan which has just concluded. Specifically, this is a quick review of the presentations that I attended which had a link (however tenuous!) to genomics. Continue reading
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.
I normally steer well clear of the topic of sequencing in newborn babies because this area raises so many social, legal and ethical questions that go way beyond the clinical/economics perspective that we’re used to considering. However, I read an interesting commentary piece the other day by Jacques Beckmann titled ‘Can we afford to sequence every newborn baby’s genome?’ which I think deserves a wider audience for two reasons. One, it reminded me of a comment that Professor Sir John Burn (director, NHS England) made during the recent Astellas Innovation Debate in London. Jonathan Dimbleby asked if he could see whole genome sequencing (WGS) being rolled out to everyone across the UK, to which he replied: “the reality is that even when we get the 100,000 Genomes Project fully operational and get it absorbed, we’ll only be doing maybe 30,000-50,000 whole genomes a year – we’d have to do 600,000 a year to catch up with the new babies”. Second, I think there are some points raised in this article that go beyond newborn screening and are directly applicable to the economic evaluation of genomic testing in a variety of clinical contexts.