New DPhil (PhD) opportunity in health economics and genomics

We have just advertised a new DPhil (PhD) position here at the Health Economics Research Centre in the area of health economics and genomics. The proposed start date is October 2021 and the full title is “Valuing the outcomes associated with genome sequencing in economic evaluations”. The student will be supervised by myself and Professor Sarah Wordsworth.

The primary aim of this project is to evaluate existing instruments used to generate quality of life weights for use in extra-welfarist economic evaluations, in terms of their capacity to capture all impacts of genome sequencing on patient wellbeing. Such instruments will include the EQ-5D-5L, the SF-36 and ICECAP capability measures. We expect the student will: 

  • Critically appraise the theoretical capacity of existing instruments to capture the impacts of genome sequencing;
  • Review the current use of these instruments in this context;
  • Generate new data on the use of these instruments in patients undergoing genome sequencing;
  • Identify instruments that effectively value the outcomes associated with genome sequencing;
  • Describe the characteristics of any new instruments that may be required.

The deadline for applications is 1200 noon UK time on Friday 8th January 2021.

If anybody has any questions about this project then please don’t hesitate to get in touch by email (james.buchanan@dph.ox.ac.uk). Please also share the details of this project with anybody who you think might be interested.

Full details of this project are available here.

New special theme section in Value in Health on Precision Medicine

In 2018, I contributed to the publication of a special theme section in Value in Health on assessing the value of clinical genomic testing. You can read a blog post about this publication here, and access the special issue here. My contribution to this was as a member of the Global Economics and Evaluation of Clinical Genomics Sequencing Working Group (GEECS), formerly known as the Population Genomics Health Economists Working Group.

I’m pleased to say that we have just published a second theme section in the same journal, this time focused on evaluation methods for moving precision medicine into practice and policy. This theme section features five papers from the GEECS team and one paper by the ISPOR Special Interest Group on Precision Medicine and Advanced Therapies. As before, the work was chaired by Kathryn A. Phillips, PhD.

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Evaluating the Outcomes Associated with Genomic Sequencing

I’ve written about evaluating the outcomes of genomic sequencing a few times in this blog, in the context of several different publications. A key issue here is that we still lack evidence on the health outcomes associated with sequencing, and a commonly cited reason for this is that health economists are unsure as to whether the QALY can fully quantify the outcomes that are important to patients when they undergo genomic testing. There isn’t a great deal of consensus on this matter, or on the issue of whether information on personal utility should feed into resource allocation decisions in this context. This methodological uncertainty may partially explain why existing economic evaluations of genomic sequencing have not gone beyond ‘narrow’ outcome measures such as diagnostic yield.

However, before abandoning QALYs in this clinical context (if this is even possible), I think there are several steps that can and should be taken to improve the evidence base on the clinical and non-clinical utility of genomic sequencing. With this in mind, I recently published an editorial in PharmacoEconomics – Open with Sarah Wordsworth titled “Evaluating the Outcomes Associated with Genomic Sequencing: A Roadmap for Future Research”, in which we expand on what these steps might be. I think this topic should be debated more widely, so if anybody has alternative views on this I’d be happy to hear them!

Just published: Value In Health theme section on assessing the value of clinical genomic testing

Around 12 months ago I joined an exciting new venture: the Population Genomics Health Economists Working Group. This group is made up of health economists and policy researchers from major institutions across the globe who have been at the forefront of the incorporation of genomics into clinical care. The group is chaired by Kathryn A. Phillips, PhD, Director of the Center for Translational and Policy Research on Personalized Medicine (TRANSPERS) at the University of California. You can find out more about the group members here.

The first key output from this working group has been published today: a themed section in the September issue of Value in Health which addresses the challenges and solutions for assessment of the value of clinical genomic testing.

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