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

Bouttell, J. , Heggie, R., Oien, K. , Romaniuk, A., VanSteenhouse, H., von Delft, S. and Hawkins, N. (2022) Economic evaluation of genomic/genetic tests: a review and future directions. International Journal of Technology Assessment in Health Care, 38(1), e67. (doi: 10.1017/S0266462322000484)

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.

• Item Type: Articles
• Additional Information: Funding Statement: J.B. is funded by a Knowledge Transfer Partnership 12310 between the University of Glasgow and BioClavis Limited. N.H., S.D., and K.O. are partly funded by Knowledge Transfer Partnership 12310 between the University of Glasgow and BioClavis Limited. H.V. and A.R. are employees of BioClavis Limited. R.H. received no funding associated with this article.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Hawkins, Professor Neil and Von Delft, Professor Stephan and Vansteenhouse, Dr Harper and Oien, Professor Karin and Bouttell, Dr Janet and Heggie, Mr Robert
• Authors: Bouttell, J., Heggie, R., Oien, K., Romaniuk, A., VanSteenhouse, H., von Delft, S., and Hawkins, N.
• College/School: College of Medical Veterinary and Life Sciences; College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Social Sciences > Adam Smith Business School > Management
• Journal Name: International Journal of Technology Assessment in Health Care
• Publisher: Cambridge University Press
• ISSN: 0266-4623
• ISSN (Online): 1471-6348
• Published Online: 01 August 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in International Journal of Technology Assessment in Health Care 38(1):e67
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher