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Economic evaluation of genomic/genetic tests: a review and future directions

Published online by Cambridge University Press:  01 August 2022

Janet Bouttell Open the ORCID record for Janet Bouttell [Opens in a new window] ,
Robert Heggie ,
Karin Oien ,
Amy Romaniuk ,
Harper VanSteenhouse ,
Stephan von Delft  and
Neil Hawkins
Janet Bouttell*
Affiliation:
Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, United Kingdom
Robert Heggie
Affiliation:
Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, United Kingdom
Karin Oien
Affiliation:
Institute of Cancer Sciences – Pathology, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, United Kingdom
Amy Romaniuk
Affiliation:
BioClavis Limited, Teaching and Learning Centre, Queen Elizabeth University Hospital, Glasgow, United Kingdom
Harper VanSteenhouse
Affiliation:
BioClavis Limited, Teaching and Learning Centre, Queen Elizabeth University Hospital, Glasgow, United Kingdom
Stephan von Delft
Affiliation:
Adam Smith Business School, University of Glasgow, Glasgow, United Kingdom REACH EUREGIO Start-Up Center, University of Münster, Münster, Germany
Neil Hawkins
Affiliation:
Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, United Kingdom
*
*Author for correspondence: Janet Bouttell, E-mail: [email protected]
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Abstract

It has been suggested that health economists need to improve their methods in order to meet the challenges of evaluating genomic/genetic tests. In this article, we set out twelve challenges identified from a rapid review of the literature and suggest solutions to the challenges identified. Two challenges were common to all economic evaluations: choice of perspective and time-horizon. Five challenges were relevant for all diagnostic technologies: complexity of analysis; range of costs; under-developed evidence base; behavioral aspects; and choice of outcome metrics. The final five challenges were pertinent for genomic tests and only these may require methodological development: heterogeneity of tests and platforms, increasing stratification, capturing personal utility; incidental findings; and spillover effects. Current methods of economic evaluation are generally able to cope with genomic/genetic tests, although a renewed focus on specific decision-makers’ needs and a willingness to move away from cost-utility analysis may be required. Certain analysts may be constrained by reference cases developed primarily for the assessment of pharmaceuticals. The combined impact of multiple challenges may require analysts to be particularly careful in setting the scope of their analysis in order to ensure that feasibility is balanced with usefulness to the decision maker. A key issue is the under-developed evidence-base and it may be necessary to rethink translation processes to ensure sufficient, relevant evidence is available to support economic evaluation and adoption of genomic/genetic tests.

Type
Article Commentary
Information
International Journal of Technology Assessment in Health Care , Volume 38 , Issue 1 , 2022 , e67
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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