Economic Evaluation in Genomic Medicine

Description

Economic Evaluation in Genomic Medicine introduces health economics and economic evaluation to genomic clinicians and researchers, while also introducing the topic to health economists.

Each chapter includes an executive summary, questions, and case studies, along with supplementary online materials, including process guides, maps, flow charts, diagrams, and economic evaluation spreadsheets to enhance the learning process.

The text can easily be used as course material for related graduate and undergraduate courses, providing a succinct overview of the existing, state-of-the-art application of economic evaluation to genomic healthcare and precision medicine.

Interrelates economic evaluation and genomic medicine
Instructs healthcare professionals and bioscientists about economic evaluation in genomic medicine
Teaches health economists about application of economic evaluation in genomic medicine
Introduces health economics and economic evaluation to clinicians and researchers involved in genomics
Includes process guides, maps, flow charts and diagrams

Front Cover 2
Economic Evaluation in Genomic Medicine 5
Copyright Page 6
Contents 7
Preface 11
1 Economic Evaluation in Health Care: Evidence-Based Medicine and Evidence-Based Health Economics 13
- The Scope of Economic Evaluation of Health Services: The Science of Economics 13
- Evidence-Based Medicine and Evidence-Based Health Economics 16
- The Necessity of Drafting Economic Evaluations 18
- References 20
2 Genomic Medicine Today: An Introduction for Health Economists 21
- Introduction 21
- Applications of Pharmacogenomics 22
  - Oncology Examples 23
- Pharmacogenomics and Genomic Medicine 22

Front Cover 2
Economic Evaluation in Genomic Medicine 5
Copyright Page 6
Contents 7
Preface 11
1 Economic Evaluation in Health Care: Evidence-Based Medicine and Evidence-Based Health Economics 13
- The Scope of Economic Evaluation of Health Services: The Science of Economics 13
- Evidence-Based Medicine and Evidence-Based Health Economics 16
- The Necessity of Drafting Economic Evaluations 18
- References 20
2 Genomic Medicine Today: An Introduction for Health Economists 21
- Introduction 21
- Applications of Pharmacogenomics 22
  - Oncology Examples 23
  - Cardiology Examples 24
  - Psychiatric Examples 25
  - Infectious Disease Examples 26
- Pharmacogenomics and Genomic Medicine 22
- Facing the Current Challenges of Genomic Medicine 26
- Education of Health Professionals 27
- Demonstration of Clinical Utility 28
- Health Care Costs 29
- Insurance and Privacy Issues 30
- Conclusions and Future Perspectives 31
- References 34
3 Economic Evaluation and Genomic Medicine: What Can They Learn from Each Other? 39
- Introduction 39
- Genomics in Health Economics 41
- Triangulating Genomics with Health Technology Assessment and Health Economics 44
- Economic Evaluation in the Postgenomic Era 45
- References 46
4 Introduction to the Technical Issues of Economic Evaluation 49
- Introduction 49
- Unique Aspects and Differentiation of CEA from Alternative Approaches 50
- AN Appropriate Measure for CEA 52
- CEA Decision Criteria 53
- The Concept of Extended Dominance 61
- Selection of Alternative Options During Economic Evaluation 65
- Valuing the Quality of Life–Cost–Utility Analysis 65
- A Conceptual Approach to QALY 69
- Assessing the Quality of an Economic Analysis 72
- Conclusions 73
- References 74
5 Advanced Methodological Aspects in the Economic Evaluation 77
- Model Types 77
- Introduction 77
- The Size of the ICER or the λ 79
- Estimates of Effectiveness 84
- Study Perspective and Cost Determination 86
- The Discount Rate 89
- Sensitivity Analysis 95
- The Value of Information and Bayesian Analysis 103
- References 107
- Conclusions 107
6 Economic Evaluation in the Genomic Era: Some Examples from the Field 109
- Introduction 109
- Using Pharmacogenomics to Prevent Adverse Events 109
- Balancing Adverse Events and Efficacy 112
- The Disease Makes a Difference 116
- Perspectives on Perspective 117
- Defining Performance Characteristics 119
- Cost-Effectiveness Analysis in Genomic Medicine and the Developing World 120
- References 123
- Conclusions 123
7 Special Requirements for Economic Evaluation and Health Technology Assessment in Genomic Medicine 127
- Introduction 127
- Analysis Costs 128
- Analysis Method 132
- Outcome of Analysis 133
- Analysis Effectiveness 135
- Conclusions 136
- References 137
8 A New Methodological Approach for Cost-Effectiveness Analysis in Genomic Medicine 143
- Introduction 143
- New Methodological Framework of the Decision-Making Process in Genomic Medicine 145
- Relaxation of Fixed λ 150
- A Simple Indicative Example 152
- An Application of the New Model in Genomic Medicine 153
- Implications 156
- Conclusions 157
- References 158
9 Conclusions and Future Perspectives 161
- Introduction 161
  - Lack of Education 161
  - This Field Is Highly Technical but Not Very “Objective” 161
  - There Is No Standard Methodology for Study Performance/Presentation 162
  - It Is Based on Multiple Assumptions 163
  - There Is Bias Because of Funding 163
  - It Uses a Different Perspective than the One Commonly Used by Clinical Scientists or Policymakers 164
  - Reproduction of Authority by the Medical Community 164
  - It Is not “Ethical” 165
  - It Increases Costs 165
- Conclusions 166
- References 167
Index 169

Author's affiliation

Vasilios Fragoulakis: University of Patras School of Health Science
Christina Mitropoulou: Erasmus University Medical Center, Department
Marc Williams: Geisinger Health System, Danville, Pennsylvan

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