The Office of Health Economics has made a number of important contributions to the understanding of the economics of stratified/precision/personalised medicines. We have contributed to improving the knowledge of both health care payers and the life sciences industry. This work promotes innovation by challenging the value of innovation, and facilitates decision making in order to improve the uptake of personalised medicine. The team has authored a number of peer reviewed papers and reports, some recent examples are cited below under three broad topics: value frameworks, innovations in pricing and cost effectiveness analyses.
This strand of research considers new elements of value for personalised medicine, value frameworks, and how they could be included health technology assessment (HTA) methods. The papers explore the benefits of personalised medicine including the value of increasing the information available to patients to make informed decisions on treatment and their future lifestyle choices. There is a growing recognition that these benefits are not valued in current QALY-based HTA methods.
and Garrison, L.
, (2017). Value assessment in precision cancer medicine. Journal of Cancer Policy
, 11, pp.48-53. DOI
Kamal-Bahl, S. and Towse, A.
, (2017). Toward a Broader Concept of Value: Identifying and Defining Elements for an Expanded Cost-Effectiveness Analysis. Value in Health
, 20(2), pp.213-216. DOI
, Mestre-Ferrandiz, J.
, Zamora, B.
(2016). The Value of Knowing and Knowing the Value: Improving the Health Technology Assessment of Complementary Diagnostics. White Paper. Office of Health Economics and European Personalised Medicine Association. [OHE blog
Wordsworth S, Buchanan J, Towse A.
(2016). Health Economic Perspectives of Genomics. Chapter 5 in the book Kumar D and Chadwick R (eds) Genomics and Society: Ethical, Legal, Cultural and Socioeconomic Implications.
Academic Press, pp. 83–117. DOI
, Towse, A.
, Garrison, L.
, Housman, L. and Ossa, D. (2013). Can and should value-based pricing be applied to molecular diagnostics? Personalized Medicine
. 10(1), 61-72. DOI
Innovations in pricing and market access agreements
This strand of research considers various pricing strategies to incentivise the R&D of personalised medicines and increase their uptake. This includes incentivising combination therapies and companion diagnostics. This research analyses economic incentives and considers risk-sharing schemes to incentivise the life sciences industry (pharmaceutical and diagnostic manufacturers) and manage the risk for the payer.
, Towse, A.
, Pearson, S., Dreitlein, W., Henshall, C. (2017). Gene therapy: evidence, value and affordability in the US health care system. J Comp Eff Res
. Nov 16. DOI
Garrison, L. and Towse, A. (2014). Economics of personalized medicine: pricing and reimbursement policies as a potential barrier to development and adoption. In: A. Culyer ed. Encyclopedia of Health Economics. San Diego, CA: Elsevier. pp. 484-490. DOI
and Garrison, L.
(2013). Economic incentives for evidence generation: promoting an efficient path to personalized medicine. Value in Health
, 16(6 Suppl), S39-S43. DOI
, Ossa, D., Veenstra, D., Carlson, J. and Garrison, L.
, (2013). Understanding the economic value of molecular diagnostic tests: Case studies and lessons learned. Journal of Personalised Medicine
, 3(4), pp.288-305. DOI
Cost effectiveness analysis
This research generally considers applications of economic evaluation methods to personalised medicine adoption decisions. These studies consider the incremental cost and additional benefit of genomic medicine, and evaluate the current evidence base to inform reimbursement decisions.
Doble, B., John, T., Thomas, D., Fellowes, A., Fox, S., Lorgelly, P
(2017). Cost-effectiveness of precision medicine in the fourth-line treatment of metastatic lung adenocarcinoma: an early decision analytic model of multiplex targeted sequencing. Lung Cancer
, 107, 22-35. DOI
Doble, B., Tan, M., Harris, A., Lorgelly, P.
(2015). Modelling companion diagnostics in economic evaluations of targeted oncology therapies: a systematic review and methodological checklist. Expert Review of Molecular Diagnostics
, 15(2), 234-254. DOI
Doble, B., Lorgelly, P.
(2015). Clinical players and health care payers: aligning perspectives on the cost-effectiveness of next-generation sequencing in oncology. Personalized Medicine
12(1), 9-12. DOI
Parisot JP, Thorne H, Fellowes A, Doig K, Lucas M, McNeil J, Doble B, Dobrovic A, John T, James PA, Lipton L, Ashley D, Hayes T, McMurrick P, Richardson G, Lorgelly P
, Fox SB, Thomas DM (2015). Cancer 2015: A prospective, population-based cancer cohort – Phase 1: feasibility of genomics-guided precision medicine in the clinic. Journal of Personalised Medicine
, 5(4), 354-369. DOI
To find more about our research on Personalised Medicine, click here