An Alternative Methodological Approach for Cost-Effectiveness Analysis and Decision Making in Genomic Medicine.
Genomic Medicine aims to improve therapeutic interventions and diagnostics, the quality of life of patients, but also to rationalize healthcare costs. To reach this goal, careful assessment and identification of evidence gaps for public health genomics priorities are required so that a more efficient healthcare environment is created. Here, we propose a public health genomics-driven approach to adjust the classical healthcare decision making process with an alternative methodological approach of cost-effectiveness analysis, which is particularly helpful for genomic medicine interventions. By combining classical cost-effectiveness analysis with budget constraints, social preferences, and patient ethics, we demonstrate the application of this model, the Genome Economics Model (GEM), based on a previously reported genome-guided intervention from a developing country environment. The model and the attendant rationale provide a practical guide by which all major healthcare stakeholders could ensure the sustainability of funding for genome-guided interventions, their adoption and coverage by health insurance funds, and prioritization of Genomic Medicine research, development, and innovation, given the restriction of budgets, particularly in developing countries and low-income healthcare settings in developed countries. The implications of the GEM for the policy makers interested in Genomic Medicine and new health technology and innovation assessment are also discussed.
1 Department of Pharmacy, University of Patras School of Health Sciences , Patras, Greece .|2 Department of Health Services Management, National School of Public Health , Athens, Greece .
Vasilios
V
Fragoulakis
3 Department of Clinical Chemistry, Erasmus University Medical Center , Rotterdam, the Netherlands .
Christina
C
Mitropoulou
3 Department of Clinical Chemistry, Erasmus University Medical Center , Rotterdam, the Netherlands .
Ron H
RH
van Schaik
2 Department of Health Services Management, National School of Public Health , Athens, Greece .
Nikolaos
N
Maniadakis
1 Department of Pharmacy, University of Patras School of Health Sciences , Patras, Greece .
George P
GP
Patrinos
D003657:Decision Making; D003695:Delivery of Health Care / Q000191:economics*; D003906:Developing Countries; D023281:Genomics; D006801:Humans; D018803:Models, Economic; D011788:Quality of Life