Economic evaluations of personalized medicine: existing challenges and current developments

Figures & data

Table 1 Systematic reviews of economic evaluations of genetics- and genomics-based technologies

Author (year)	Date searched	Focus of systematic review	Total studies identified	PGx studies identified	Quality assessment conducted
Hatz et al (2014)^Citation7	1950 to February 2013	Economic evaluations of genetic health technologies that used LYG or QALY as outcomes	84 studies	Not reported	Stringent inclusion criteria based on adherence to an economic evaluation checklist
Phillips and Van Bebber (2004)^Citation10	1950 to July 2004	Cost-effectiveness analyses of pharmacogenomic interventions	11 studies	11 studies	Assessment of studies’ quality by stringent inclusion criteria and clear description of studies Identification of key drivers of cost-effectiveness and future research priorities
Phillips et al (2014)^Citation6	1976–2011	Economic evaluations of genetic health technologies that are available or soon to be available that used QALY as the outcome	59 studies	Not reported	Inclusion criteria based on studies being listed in a systematically compiled registry of published economic evaluations
Vegter et al (2010)^Citation11	2000 to July 2010	Economic evaluations of pharmacogenetic and genomic screening programs	42 studies	42 studies	Discussion of contents of reviewed studies and adherence to key aspects of pharmacoeconomic guidelines
Vegter et al (2008)^Citation12	2000 to December 2007	Economic evaluations of pharmacogenetic and genomic screening programs	20 studies	20 studies	Discussion of contents of reviewed studies and adherence to pharmacoeconomic guidelines
Wong et al (2010)^Citation13	1950 to October 2009	Economic evaluations of pharmacogenetic interventions	34 studies	34 studies	Assessment of quality of reviewed studies using a published quantitative grading system

Abbreviations: LYG, life years gained; PGx, pharmacogenetic; QALY, quality adjusted life year.

Table 2 Selected examples of genetics-based companion diagnostics

Companion diagnostic	Purpose
Testing for somatic variations
ALK test	To predict response to crizotinib therapy
EGFR test	To predict response to erlotinib, gefitinib, or afatinib therapy
HER2 test	To predict response to trastuzumab or lapatinib therapy
Testing for germ line genetic variations
CYP2C9 test	To predict the safety and efficacy of warfarin therapy
CYP2C19 test	To predict the safety and efficacy of patients on clopidogrel
CYP2D6 test	To predict the safety and efficacy of codeine therapy
HLA-B*1502 test	To predict the safety of carbamazepine therapy based on the risk of hypersensitivity
HLA-B*5701 test	To predict the safety of abacavir therapy based on the risk of hypersensitivity
TPMT test	To predict the safety of azathioprine therapy based on the risk of neutropenia
UGT1A1 test	To predict the safety of irinotecan chemotherapy based on the risk of neutropenia

Note: Data from US Food and Drug Administration (2014).¹⁹

Abbreviations: ALK, anaplastic lymphoma kinase; CYP, cytochrome P450; EGFR, epidermal growth factor receptor; HER2, human epidermal growth factor receptor 2; HLA-B, human leukocyte antigen; TPMT, thiopurine methyltransferase; UGT, uridine diphospho glucuronosyltransferase.

HatzMHSchremserKRogowskiWHIs individualized medicine more cost-effective? A systematic reviewPharmacoeconomics201432544345524574059

 PubMed Web of Science ®Google Scholar

PhillipsKAVan BebberSLA systematic review of cost-effectiveness analyses of pharmacogenomic interventionsPharmacogenomics2004581139114915584880

 PubMed Web of Science ®Google Scholar

PhillipsKASakowskiJATrosmanJDouglasMPLiangSYNeumannPThe economic value of personalized medicine tests: what we know and what we need to knowGenet Med201416325125724232413

 PubMed Web of Science ®Google Scholar

VegterSJansenEPostmaMJBoersmaCEconomic evaluations of pharmacogenetic and genomic screening programs: update of the literatureDrug Dev Res2010718492501

 Web of Science ®Google Scholar

VegterSBoersmaCRozenbaumMWilffertBNavisGPostmaMJPharmacoeconomic evaluations of pharmacogenetic and genomic screening programmes: a systematic review on content and adherence to guidelinesPharmacoeconomics200826756958718563949

 PubMed Web of Science ®Google Scholar

WongWBCarlsonJJTharianiRVeenstraDLCost effectiveness of pharmacogenomics: a critical and systematic reviewPharmacoeconomics201028111001101320936884

 PubMed Web of Science ®Google Scholar

US Food and Drug AdministrationPharmacogenomic Biomarkers in Drug Labeling2014 Available from: http://www.fda.gov/drugs/scienceresearch/researchareas/pharmacogenetics/ucm083378.htmAccessed May 1, 2014

 Google Scholar