Personalized medicine and economic evaluation in oncology: all theory and no practice?
The clinical definition of personalized medicine (PM) is closely related to that of pharmacogenomics. Ideally, PM could lead the pharmaceutical industry to differentiate products by subgroups of patients with the same pathology and find new gene targets for drug discovery. Here, we focus on the potential impact of PM on the design of clinical trials and economic evaluations limited to oncology (its first and main field of application). Then, we assess the European economic evaluations focused on trastuzumab and cetuximab, the two drugs usually mentioned as emblematic examples of targeted therapies. Clinical results of PM in oncology have not been as encouraging as hoped so far. Of course, economic evaluations on targeted therapies cannot help overcome the lack of clinical evidence for most of them. The two paradigmatic examples of cetuximab and trastuzumab indicate that the methodological implications on economic evaluations debated in the literature are more theoretical than practical.
a 1 IRCCS Institute for Pharmacological Research "Mario Negri", Ranica, 24020, Italy.
Livio
L
Garattini
a 1 IRCCS Institute for Pharmacological Research "Mario Negri", Ranica, 24020, Italy.
Alessandro
A
Curto
b 2 UCL Medical School (Royal Free Campus), Royal Free Medical School, London, NW3 2PF, UK.
Nick
N
Freemantle
D000970:Antineoplastic Agents / Q000191:economics / Q000494:pharmacology*; D000068818:Cetuximab / Q000191:economics / Q000494:pharmacology; D015195:Drug Design; D055808:Drug Discovery / Q000379:methods; D004345:Drug Industry / Q000191:economics / Q000379:methods; D006801:Humans; D058990:Molecular Targeted Therapy; D009369:Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D010597:Pharmacogenetics; D057285:Precision Medicine / Q000191:economics / Q000379:methods*; D000068878:Trastuzumab / Q000191:economics / Q000494:pharmacology
D000970:Antineoplastic Agents; D000068878:Trastuzumab; D000068818:Cetuximab
cetuximab; economic evaluation; oncology; personalized medicine; targeted therapy; trastuzumab