Genomics, Healthcare and Public Policy

Williams, P. and Clow, S.

Monograph
October 1999

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This Conference on Genomics, Healthcare and Public Policy, organised by the Office of Health Economics in collaboration with the School of Public Policy, University College London, and Pharmaceutical Partners for Better Healthcare, examined the status and likely consequences of healthcare applications of genetics. Advances in genetics will open up opportunities for universities and industry, they will induce changes in the practice of medicine, and lead to alterations in the structure and organization of health services in many countries.

Genomics is the study of the genome as a whole - the sequence of DNA nucleotides in the cell and how this provides the information for the cell to function and reproduce itself. An important extension of this is the concept of population genomics, the study of how the genetic constitution of a population is related to health and disease in that population. Genetics is the study of individual genes and their roles in cell functioning and reproduction. Mutations in specific genes often produce, or contribute to, diseases, thus defining the disease as a' genetic disease'. Therefore, genetic research can be considered a category (perhaps the most critical category) of genomic research.

Genomics offers great potential benefits, but current reimbursement strategies may be inadequate to encourage appropriate development of long-lived and more specific gene therapies, which are two of the most immediate potential advantageous uses of genomics. Reimbursement needs to be approached much more flexibly in terms of breaking down the silo approach to the drug budget versus other services, thinking in terms of the longer-term benefits and being willing to pay the expected value of future, as well as present-day, benefits.