Abstract
The budget for health care service provision is finite and under increasing pressure in part due to technological innovation in healthcare. Newer treatments in oncology are often more expensive than current treatment options and in some cases require additional resources such as molecular tumour testing to determine eligibility or imaging to monitor disease progression and continued eligibility. This chapter describes some key economic concepts that can be applied to help decision-makers make difficult decisions about which treatments or tests are the best use of healthcare resources. Four methods of economic evaluation are described, briefly. A more detailed description of how to conduct and interpret a cost-effectiveness analysis is then presented using the example of adding CYP2D6 testing to inform prescribing decisions for tamoxifen. The current level of published economic evidence in oncology pharmacogenetics is briefly described. The chapter concludes by mentioning some other economic methods that may prove useful in the field of oncology pharmacogenetics.
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References
Aydiner A, Tas F (2008) Meta-analysis of trials comparing anastrozole and tamoxifen for adjuvant treatment of postmenopausal women with early breast cancer. Trials 9:47
Brennan A, Akehurst R (2000) Modelling in health economic evaluation: What is its place? What is its value? Pharmacoeconomics 17:445–459
Centre for Reviews and Dissemination. NHS Economic Evaluation Database Handbook (3rd Ed). April 2007. http://www.york.ac.uk/inst/crd/pdf/nhseed-handb07.pdf (accessed 4 August 2009)
Claxton K (1999) The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies. J Health Econ 18:341–364
Claxton K, Schulpher M, McCabe C et al (2005) Probabilistic sensitivity analysis for NICE technology assessment: not an optional extra. Health Econ 14:339–347
Coast J (2004) Is economic evaluation in touch with society’s health values? BMJ 329:1233–1236
Danzon P, Towse A (2002) The economics of gene therapy and of pharmacogenetics. Value Health 5:5–13
Drummond MF, Jefferson TO (1996) Guidelines for authors and peer reviewers of economic submissions to the BMJ. The BMJ Economic Evaluation Working Party. BMJ 313:275–283
Elliott RA, Payne K (2005) Essentials of Economic Evaluation in Health Care. The Pharmaceutical Press, London
Flowers CR, Veenstra D (2004) The role of cost-effectiveness analysis in the era of pharmacogenomics. Pharmacoeconomics 22:481–493
Garrison LP, Austin MJF (2007) The economics of personalized medicine: a model of incentives for value creation and capture. Drug Inf J 41:501–509
Grosse SD, Wordsworth S, Payne K (2008) Economic methods for valuing the outcomes of genetic testing: beyond cost-effectiveness analysis. Genet Med 10:648–654
Hornberger J, Cosler LE, Lyman GH (2005) Economic analysis of targeting chemotherapy using a 21-gene RT-PCR assay in lymph-node negative, estrogen receptor-positive, early-stage breast cancer. Am J Manag Care 11:313–324
Laking G, Lord J, Fischer A (2006) The economics of diagnosis. Health Econ 15:1109–1120
Lidgren M, Jonsson B, Rehnberg C, Willking N, Bergh J (2008) Cost-effectiveness of HER2 testing and 1-year adjuvant trastuzumab therapy for early breast cancer. Ann Oncol 19:487–495
McCabe C, Claxton K, Culyer AJ (2008) The NICE cost-effectiveness threshold. What it is and what that means. Pharmacoecnomics 26:733–744
National Institute for Health and Clinical Excellence (NICE) technology appraisal guidance 34 (2002) Guidance on the use of trastuzumab for the treatment of advanced breast cancer. NICE, London
National Institute for Health and Clinical Excellence (NICE) technology appraisal guidance 107 (2006) Trastuzumab for the adjuvant treatment of early-stage HER2-positive breast cancer. NICE, London
National Institute for Health and Clinical Excellence (NICE) guide to the methods of health technology appraisal (2008) NICE, London
Obradovic M, Mrhar A, Kos M (2008) Cost effectiveness of UGT1A1 genotyping in second-line, high-dose, once every 3-weeks irinotecan monotherapy treatment of colorectal cancer. Pharmacogenomics 9:539–549
Philips Z, Bojke L, Sculpher M, Claxton K, Golder S (2006) Good practice guidelines for decision-analytic modelling in health technology assessment: a review and consolidation of quality of assessment. Pharmacoeconomics 24:355–371
Phillips KA, Van Bebber SL (2005) Measuring the value of pharmacogenomics. Nat Rev Drug Discov 4:500–509
Phillips KA, Van Bebber S, Marshall D, Walshe J, Thabane L (2006) A review of studies examining stated preferences for cancer screening. Prev Chronic Dis 3:1–8
Rawlins MD, Culyer AJ (2004) National institute for clinical excellence and its value judgments. BMJ 329:224–227
Shih YT, Pusztai L (2006) Do pharmacogenomic tests provide value to policy makers? Pharmacoeconomics 24:1173–1177
Van Bebber SL, Liang S, Phillips KA, Marshall D, Walsh J, Kulin N (2007) Valuing personalized medicine: willingness to pay for genetic testing for colorectal cancer risk. Personalized Med 4:341–350
van den Akker-van Marle ME, Gurwitz D, Detmar SB, et al (2006) Cost-effectiveness of pharmacogenomics in clinical practice: a case study of thiopurine methyltransferase genotyping in acute lymphoblastic leukemia in Europe. Pharmacogenomics 7:783–792
Vegter S, Boersma C, Rozenbaum M, Wilffert B, Navis G, Postma MJ (2008) Pharmacoeconomic evaluations of pharmacogenetic and genomic screening programmes. A systematic review on content and adherence to guidelines. Pharmacoeconomics 26:569–587
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Payne, K. (2010). Economics of Cancer Pharmacogenetics. In: Newman, W. (eds) Pharmacogenetics: Making cancer treatment safer and more effective. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-8618-1_12
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DOI: https://doi.org/10.1007/978-90-481-8618-1_12
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