Genomics at the 2015 iHEA meeting in Milan

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

Cost-effectiveness analysis and genetics – the zombie technique that will never die

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:

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Personalised Medicine and Resource Allocation

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.

Welfarism versus extra-welfarism: an important analytical decision in genomics?

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.

Genomics, the data revolution and health economics – the 2015 Astellas Innovation Debate

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/.

Making better decisions in genomics

Happy New Year everybody. One of my new year’s resolutions is to post more frequently in 2015, and I’m going to start by taking a look at a recently published paper by Susan Snyder and colleagues titled “Economic evaluation of pharmacogenomics: a value-based approach to pragmatic decision making in the face of complexity”. This is a review paper that takes a look at the need for, and current use of economic evaluations in pharmacogenomics, identifying both obstacles to progress and also areas where, actually, we’re doing ok at the moment. There have been a few papers covering similar ground in the past couple of years (interested readers should check out Faulkner et al., Annemans et al. and, in a shameless act of self-promotion, one of my publications) and I think all of them have made a significant contribution to the literature in one way or another. Snyder et al. do so as well. Rather than review their paper in full, I wanted to focus on their unique contribution by pulling out a couple of points of interest that might prompt further discussion.

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Introduction

Hello. Chances are you’re a health economist, although you might also be a researcher in a different field of healthcare. You might even be a scientist (apologies in advance for any bad science that might follow). Whoever you are, you’re very welcome. The aim of this introductory post is to tell you what you should expect from this blog. Hopefully you’ll be sufficiently intrigued to return, read some more articles and contribute to the growing debate surrounding the application of standard health economic methods in the field of genomics.

This blog is going to assume that you know a little bit about genomics. Specifically, this blog is going to assume that you have at least read the “What are genomic technologies?” section of this blog, a short introduction for a layperson who already has a little bit of science knowledge. Of course, many of you will have a greater knowledge of genetics and genomics than this simple introduction, but this blog is intended to be broadly accessible to stimulate wide debate, so the aim is to keep the genomics jargon to a minimum. This blog is also going to assume that the average reader has some basic knowledge about health economics. Those who don’t could do a lot worse than frequent the excellent “Academic Health Economists’ Blog”.

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