The Economics Of Genomic Medicine
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The Economics Of Genomic Medicine
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Author : Institute of Medicine
language : en
Publisher: National Academies Press
Release Date : 2013-07-20
The Economics Of Genomic Medicine written by Institute of Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-07-20 with Medical categories.
The sequencing of the human genome and the identification of links between specific genetic variants and diseases have led to tremendous excitement over the potential of genomics to direct patient treatment toward more effective or less harmful interventions. Still, the use of whole genome sequencing challenges the traditional model of medical care where a test is ordered only when there is a clear indication for its use and a path for downstream clinical action is known. This has created a tension between experts who contend that using this information is premature and those who believe that having such information will empower health care providers and patients to make proactive decisions regarding lifestyle and treatment options. In addition, some stakeholders are concerned that genomic technologies will add costs to the health care system without providing commensurate benefits, and others think that health care costs could be reduced by identifying unnecessary or ineffective treatments. Economic models are frequently used to anticipate the costs and benefits of new health care technologies, policies, and regulations. Economic studies also have been used to examine much more specific issues, such as comparing the outcomes and cost effectiveness of two different drug treatments for the same condition. These kinds of analyses offer more than just predictions of future health care costs. They provide information that is valuable when implementing and using new technologies. Unfortunately, however, these economic assessments are often limited by a lack of data on which to base the examination. This particularly affects health economics, which includes many factors for which current methods are inadequate for assessing, such as personal utility, social utility, and patient preference. To understand better the health economic issues that may arise in the course of integrating genomic data into health care, the Roundtable on Translating Genomic-Based Research for Health hosted a workshop in Washington, DC, on July 17-18, 2012, that brought together economists, regulators, payers, biomedical researchers, patients, providers, and other stakeholders to discuss the many factors that may influence this implementation. The workshop was one of a series that the roundtable has held on this topic, but it was the first focused specifically on economic issues. The Economics of Genomic Medicine summarizes this workshop.
Health Economics Of Genomic Medicine
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Author : Sarah Wordsworth
language : en
Publisher:
Release Date : 2022-01-15
Health Economics Of Genomic Medicine written by Sarah Wordsworth and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2022-01-15 with categories.
Although genomic medicine is still a fairly new clinical area, the history of health economics involvement in genomics has a longer history than might be anticipated. Some of the earliest health economics input into genomics was in areas such as neonatal and newborn screening, where health economists contributed to decisions about adding new conditions into newborn screening programmes worldwide. More recently, the first human genome was only sequenced in 2003, costing between US$500 million and US$1 billion. However, by 2008 costs had fallen to a level where so called 'next-generation sequencing (NGS)' approaches started to enter clinical research. NGS approaches allow either the whole genome using methods such as whole-genome sequencing (WGS) or parts of it using whole-exome sequencing (WES) or targeted panels to be sequenced in hours with increased sensitivity compared to older less advanced genetic testing approaches. These sequencing approaches provide information that can inform diagnosis, prognosis and clinical management for a variety of disorders, such as rare diseases and some cancers. However, the current costs are still too expensive for some health care providers and the benefit of the tests is largely unknown. Indeed, a lack of evidence on the cost-effectiveness of novel genomic technologies such as WGS is considered a key translational challenge. This is partly because economic evaluations of genomic technologies often fall outside the remit of health technology assessment (HTA) agencies, such as NICE and PBAC. Where they are undertaken (in a HTA context), the methods used for the assessment sometimes differ from those recommended by HTA agencies for cost-effectiveness analysis. This is against a background of uncertainty as to whether the terms precision medicine, personalised medicine or genomic medicine best capture this space in health care. Methodological challenges Some applications of genomic sequencing generate information that may not improve quality of life (as measured using preference-based health-related quality of life [HRQoL] instruments such as the EuroQol-five dimensions questionnaire) or extend life expectancy. One example is the use of WGS and WES to guide diagnosis in autism spectrum disorder. However, genomic sequencing results may influence patient wellbeing via non-clinical routes, generating 'personal utility'. This is a particular issue for individuals with rare diseases, who often have lengthy diagnostic journeys but few (if any) treatment options available once they receive a diagnosis. This could also be an issue if individuals without known health problems (healthy cohorts) undergo genomic sequencing and find out that they have an elevated risk of a disease, but no preventive action can be taken to manage this risk. With respect to costs, the costs of undertaking genomic tests are only one component of the cost of the overall genomic testing process. The costs that are incurred beyond those associated with the production of genomic information (so probably beyond the scope of any national tariffs that might be generated) include the costs of bioinformatics analysis, interpretation of results in multidisciplinary team (MDT) meetings and genetic counselling services. Such issues have raised questions about whether or not genomics is exceptional for health economists - possibly not, but the combined issues perhaps lead to it often requiring additional attention. There is also a consideration of the importance of accounting for the 'personal' when evaluating personalized medicine and considers the extent to which extra-welfarist and welfarist approaches to economic evaluation achieve this objective. Extra-welfarist approaches are currently used by many health technology assessment agencies but may not capture all of the outcomes that are important to patients in this context. Extensions to the extra-welfarist approach that might better capture the 'personal' are outlined, including multi-criteria decision analysis and the capability approach. Evidence A recent literature review identified only 36 economic evaluations of either WGS or WES, six of which were cost-effectiveness analyses using diagnostic yield as the outcome measure. Only two publications presented cost-utility analyses using quality-adjusted life-years (QALYs) as the measure of health outcomes. HTA agencies generally require data on survival and quality of life when evaluating new healthcare interventions, which, when combined, allow clinical utility to be quantified using QALYs. However, existing studies have primarily quantified the clinical utility of genomic tests in terms of changes in diagnostic yield. Methodological uncertainty among health economists is one potential explanation for the lack of evidence on the health outcomes associated with genomic sequencing. Over the past decade, health economists have repeatedly questioned whether metrics such as the QALY in genomic medicine, which focuses on clinical utility, can fully quantify the outcomes that are important to patients when they undergo genomic testing. Policy picture There are high-level discussions in several countries, including the UK, about extending the use of genomic sequencing into newborning screening, so effectively screening everyone at birth for a large range of conditions, far more than those currently being screened for and which there might not be treatments for yet. This is in addition to long term epidemiological and health economic discussions on using newborn screening for conditions such as hereditary hemochromatosis. A further area of uncertainty is the use of genomic sequencing in 'healthy populations', including direct to consumer testing (private genetic tests). In a public health care system setting, the UK Department of health is exploring the value of establishing a healthy cohort of volunteer. Furthermore, research studies are assessing the costs and effects of polygenetic risk scores in the context of primary care as an opportunistic 'health check' approach, which could incorporate risks for cardiovascular disease, diabetes, different cancers and conditions such as chrohn's disease etc. Clearly, there are health economic questions to be asked about the downstream costs and consequences of genomic tests in these newborn and 'healthy' populations. In cancer, there are discussions about how to handle the new invention of agnostic cancer drugs (which essentially target the mutation rather than the cancer, so the same drug can treat several cancers). This is an area where assessments are going through HTA agencies who are unsure about the best approaches to adopt to these assessments where drug companies are putting forward a drug for assessment that can potentially treat different cancers with very different disease profiles. These developments require careful consideration from many perspectives, including health economics. Besides highlighting some of the challenges in assessing the economic impact of genomic medicine and the use of advanced (and less advanced) technologies, the book will propose potential solutions to these key challenges. For example, in terms of data availability, one obstacle to translating genomic sequencing into routine health care has been a lack of large randomised controlled clinical trials data for health economists and others to use to populate cost-effectiveness analyses (CEAs). Arguably, in response, reimbursement decisions have moved towards lower evidentiary standards, with the development of managed access programs that hope to balance the intense pressure for patient access with the need to consider the sustainability objectives of health care systems. Single arm trials are common for assessing clinical utility of precision medicine. By excluding a counterfactual, these trials introduce outcomes uncertainty through their inability to establish causal treatment effects. In this section of the book, we illustrate the application of quasi-experimental methods for evaluating precision medicine in case studies linking real-world big data and single arm trials. A further potential option here might be provided by 'big data' can be used to partially support CEAs in genomics. Advanced genomic sequencing is considered to be a prominent example of big data because of the quantity and complexity of data it produces and because it presents an opportunity to use powerful information sources that could reduce clinical and health economic uncertainty at a patient level. The creation of large national sequencing initiatives with sequencing data linked to clinical data (including health outcomes) and resource use data such as hospital episode statistics data and claims data. Large-scale sequencing projects such as the 100,000 Genome Project in the UK and the All of Us Program in the US are collecting an unprecedented amount of genomic, clinical and healthcare resource use data on individuals with cancer or rare diseases, as well as healthy individuals. Some of these large-scale projects are now approaching completion, and national health services are deciding whether WGS and WES should be translated into clinical practice for specific disorders.
Economic Evaluation In Genomic And Precision Medicine
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Author :
language : en
Publisher: Academic Press
Release Date : 2023-04-19
Economic Evaluation In Genomic And Precision Medicine written by and has been published by Academic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023-04-19 with Medical categories.
Economic Evaluation in Genomic and Precision Medicine provides an in-depth examination of essential concepts, protocols and applications of economic evaluation in genomic and precision medicine. Contributions from leading international medical geneticists and health economists compile new ways to effectively assess the costs and outcomes of different genomic care pathways, implement cost-effective medical interventions, and enhance the value of genomic and precision healthcare. Foundational chapters and discipline-specific case studies cover topics ranging from the economic analysis of genomic trial design, to health technology assessment of next-generation sequencing, ethical aspects, economic policy in genomic medicine, and pricing and reimbursement in clinical genomics. Introduces clinicians, researchers and students to essential concepts, protocols and applications of economic evaluation in genomic and precision medicine Demonstrates, through foundational chapters and discipline-specific case studies, how to assess the relative costs and outcomes of different genomic care pathways and implement cost-effective budgets Establishes clear precedents on how genomic technologies can be leveraged to simultaneously reduce costs and enhance the value of healthcare Features contributions from leading international medical geneticists and health economists that are actively evolved in economic assessments of genomic and precision medicine
Economic Evaluation In Genomic Medicine
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Author : Vasilios Fragoulakis
language : en
Publisher: Academic Press
Release Date : 2015-03-20
Economic Evaluation In Genomic Medicine written by Vasilios Fragoulakis and has been published by Academic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015-03-20 with Science categories.
Economic Evaluation in Genomic Medicine introduces health economics and economic evaluation to genomic clinicians and researchers, while also introducing the topic to health economists. Each chapter includes an executive summary, questions, and case studies, along with supplementary online materials, including process guides, maps, flow charts, diagrams, and economic evaluation spreadsheets to enhance the learning process. The text can easily be used as course material for related graduate and undergraduate courses, providing a succinct overview of the existing, state-of-the-art application of economic evaluation to genomic healthcare and precision medicine. Interrelates economic evaluation and genomic medicine Instructs healthcare professionals and bioscientists about economic evaluation in genomic medicine Teaches health economists about application of economic evaluation in genomic medicine Introduces health economics and economic evaluation to clinicians and researchers involved in genomics Includes process guides, maps, flow charts and diagrams
Genomic Medicine In Emerging Economies
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Author : George Patrinos
language : en
Publisher: Academic Press
Release Date : 2018-06-29
Genomic Medicine In Emerging Economies written by George Patrinos and has been published by Academic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-06-29 with Science categories.
Genomic Medicine in Resource-limited Countries: Genomics for Every Nation provides in-depth analysis and key examples of the implementation of medical genomics in low-income nations across the globe, demonstrating how this advancing medical science has not only transformed health systems, but also led to improved patient care in Indonesian, Nepalese, Chilean, Malaysian, Tanzanian, Argentinian, Chinese, Sri Lankan and Columbian populations, among others. In addition to defining tools, diagnostics and treatment pathways at the population-wide level for medical geneticists, genomic researchers and public health workers, this book offers a case-study based approach that helps users understand how genomic medicine is used in disease-management. Examines essential concepts and protocols, and economic, social and legal considerations related to the implementation of genomic medicine in resource-limited nations Features concrete success stories of the implementation of medical genomics in Indonesian, Nepalese, Chilean, Malaysian, Tanzanian, Argentinian, Chinese, Sri Lankan and Columbian populations, amongst others Provides tools, diagnostics and treatment pathways for medical geneticists, genomic researchers and public health workers to apply in their own work Establishes clear precedents on how genomic technologies can be accessed by nations with limited means and financial support for healthcare
Socio Economics Of Personalized Medicine In Asia
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Author : Shirley Sun
language : en
Publisher: Routledge
Release Date : 2016-07-01
Socio Economics Of Personalized Medicine In Asia written by Shirley Sun and has been published by Routledge this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-07-01 with Social Science categories.
The second decade of the twenty-first century has witnessed a surging interest in personalized medicine with the concomitant promise to enable more precise diagnosis and treatment of disease and illness, based upon an individual’s unique genetic makeup. In this book, my goal is to contribute to a growing body of literature on personalized medicine by tracing and analyzing how this field has blossomed in Asia. In so doing, I aim to illustrate how various social and economic forces shape the co-production of science and social order in global contexts. This book shows that there are inextricable transnational linkages between developing and developed countries and also provides a theoretically guided and empirically grounded understanding of the formation and usage of particular racial and ethnic human taxonomies in local, national and transnational settings. The Open Access version of this book, available at http://www.taylorfrancis.com/doi/view/10.4324/9781315537177 has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.
Genomics And The Reimagining Of Personalized Medicine
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Author : Richard Tutton
language : en
Publisher: Routledge
Release Date : 2016-04-15
Genomics And The Reimagining Of Personalized Medicine written by Richard Tutton and has been published by Routledge this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-04-15 with Medical categories.
Drawing on insights from work in medical history and sociology, this book analyzes changing meanings of personalized medicine over time, from the rise of biomedicine in the twentieth century, to the emergence of pharmacogenomics and personal genomics in the 1990s and 2000s. In the past when doctors championed personalization they did so to emphasize that patients had unique biographies and social experiences in the name of caring for their patients as individuals. However, since the middle of the twentieth century, geneticists have successfully promoted the belief that genes are implicated in why some people develop diseases and why some have adverse reactions to drugs when others do not. In doing so, they claim to offer a new way of personalizing the prediction, prevention and treatment of disease. As this book shows, the genomic reimagining of personalized medicine centres on new forms of capitalization and consumption of genetic information. While genomics promises the ultimate individualization of medicine, the author argues that personalized medicine exists in the imaginative gap between the problems and limits of current scientific practices and future prospects to individualize medical interventions. A rigorous, critical examination of the promises of genomics to transform the economics and delivery of medicine, Genomics and the Reimagining of Personalized Medicine examines the consequences of the shift towards personalization for the way we think about and act on health and disease in society. As such, it will be of interest to scholars and students of the sociology of medicine and health, science and technology studies, and health policy.
Genomics
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Author : John E. Antonopoulos
language : en
Publisher:
Release Date : 2000
Genomics written by John E. Antonopoulos and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2000 with Economic development categories.
GENOMICS, Global Economics, is the Twenty First Century Economics. The economic and financial so far epidemic crises are tiny bits in front of the ones that will follow with mathematical sequence. Instant global capital movements have not even the direction and controls of a national Central Bank. World Trade Organization's open market of goods and services, capital, and technology, but not all the factors of Production, as Labor, deteriorate the Terms of Trade of the small economies. The weak currencies are crushed by the few strong ones; which face their own problems. The unemployment, world poverty, and the unstable financial markets will enhance negative psychology, the strong interests, and speculation; the result will create uncontrollable epidemic crises. New Protectionism is difficult and more harmful. The cosmogonic advances in Technology, Sciences, Communications, Transport- ation, Medicine, International Relations, changed Economics completely. Genomics is the next natural step of World Trade Organization and the International Monetary Fund. Zero basis transformation of Economics is not enough. An ideal, a priori system will contain tomorrow's necessary elements, principles, and values. These great advances and the keen global problems dictate Genomics. The book reviews and restates Economics and creates Genomics. The amassed colossal global economic and financial problems cannot be dealt with the existing Economics and Global Organizations, as: WTO, IMF, World Bank, European Union, and the others. A new, radical reconstruction is needed. It presents the Twenty First Century's Economics. It is an explosive combination of known facts and new ideas. Genomics comes from Ge (G?) Earth, the shortest term for Globe, World, and nomia, nomics. Economia meant the household administration. The term was used for the economics of the city-state, the state, the international organizations, and now for the Global Society. Therefore, the exact term must be Global-nomics or Genomics. Economics or Genomics is a broad term and science. It goes beyond the numbers, the goods and services, and the maximization of the human results, as today. It is a way of thinking, as legal, technical thinking. The book reviews and redefines Economics/Genomics. "Genomics is the science that studies how the individuals, families, states, and the global society choose, with or without the use of money, to employ scarce productive resources, which could have alternative uses, to produce various commodities and services over time and distribute them to consumption now or for the future, among the above parties, under certain Principles, Values, and Laws, aiming at satisfying the Human Wants, and making all Citizens improve their lives, in free and healthy societies, and in a clean, not abused Natural Environment." Technology, sciences, transportation and communications, the global sales, international relations, the World Trade Organization, interdependence of markets, the Babel of currencies, strategic weapons, raw materials, overpopulation, the refugees and immigrants, the poor and rich, waste and depletion of the natural resources, pollution, poisons, narcotics, space, epidemic crises press for the Global Economics, Genomics, that deals both with the micro- and macroeconomics, on a national and global basis. GECON (GENOMIC CONGRESS), an equivalent to the United Nations Organization, directs and controls Genomics and the Global Market. The number of the Member's Representatives depend upon their population and GNP. Semi-autonomous branches will be at six regions and in every member nation. GEMO (GENOMIC MONEY) will be the single global Money. There has always been the strong nation's currency
Genomics And Society
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Author : Dhavendra Kumar
language : en
Publisher: Academic Press
Release Date : 2015-10-29
Genomics And Society written by Dhavendra Kumar and has been published by Academic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015-10-29 with Science categories.
Genomics and Society; Ethical, Legal-Cultural, and Socioeconomic Implications is the first book to address the vast and thorny web of ELSI topics identified as core priorities of the NHGRI in 2011. The work addresses fundamental issues of biosociety and bioeconomy as the revolution in biology moves from research lab to healthcare system. Of particular interest to healthcare practitioners, bioethicists, and health economists, and of tangential interest to the gamut of applied social scientists investigating the societal impact of new medical paradigms, the work describes a myriad of issues around consent, confidentiality, rights, patenting, regulation, and legality in the new era of genomic medicine. Addresses the vast and thorny web of ELSI topics identified as core priorities of the NHGRI in 2011 Presents the core fundamental issues of biosociety and bioeconomy as the revolution in biology moves from research lab to healthcare system Describes a myriad of issues around consent, including confidentiality, rights, patenting, regulation, and more
Applied Genomics And Public Health
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Author : George P. Patrinos
language : en
Publisher: Academic Press
Release Date : 2019-11-13
Applied Genomics And Public Health written by George P. Patrinos and has been published by Academic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-11-13 with Science categories.
Applied Genomics and Public Health examines the interdisciplinary and growing area of how evidence-based genomic knowledge can be applied to public health, population health, healthcare and health policies. The book gathers experts from a variety of disciplines, including life sciences, social sciences, and health care to develop a comprehensive overview of the field. In addition, the book delves into subjects such as pharmacogenomics, genethics, big data, data translation and analysis, economic evaluation, genomic awareness and education, sociology, pricing and reimbursement, policy measures and economic evaluation in genomic medicine. This book is essential reading for researchers and students exploring applications of genomics to population and public health. In addition, it is ideal for those in the biomedical sciences, medical sociologists, healthcare professionals, nurses, regulatory bodies and health economists interested in learning more about this growing field. Explores the growing application of genomics to population and public health Features internationally renowned contributors from a variety of related fields Contains chapters on important topics such as genomic data sharing, genethics and public health genomics, genomics and sociology, and regulatory aspects of genomic medicine and pharmacogenomics