Wednesday, February 21, 2018

Very Brief Blog: The Messy State of Tech Assessments and Economics in Genomics (two papers)

Two current articles, both subscription, cast a light on the still-debated state of health economics and technology evaluations in genomic medicine.

For readers of Genomeweb....NICE is currently reviewing the whole field of breast cancer prognostic tests (such as Oncotype Dx, Mammaprint, Prosigna, Endopredict, and others).   A few weeks ago, the news was that NICE had provisionally found none of these to be cost-effective.   Public comment was requested.

On February 7, 2018, Genomeweb's Monika Ashford provides a very detailed, test by test rundown of public comments submitted and argumentations used (here).   Much discussion of where the NICE report could be wrong, data misinterpreted, conclusions incorrect, important points overlooked, and so on.

Also under subscription, see an article with the promising title, "Cost effectiveness analyses of genetic and genomic diagnostic tests," by Payne et al., as an Advance Epub in Nature Reviews Genetics (here).   While the title is promising, the 12-page review actually walks the reader through a wide range of what the authors describe as uncertainties, dilemmas, puzzles, missing data, and contentious issues... All of which would be faced in producing anything that is a strong statement on the "cost effectiveness of genetics." 


Proposed legislation would instruct the US HHS to review and report on the effectiveness of genomics.