Is Individualized Medicine More Cost-Effective? A Systematic Review

Abstract

IM neither seems to display superior cost-effectiveness than other types of medical interventions nor to be economically inferior. Instead, rather than 'whether' healthcare was individualized, the question of 'how' it was individualized was of economic relevance.

Are whole-exome and whole-genome sequencing approaches cost-effective? A systematic review of the literature

“…As the costeffectiveness of WES and WGS is probably dependent on clinical context, study timing, patient population, and other health system factors, we are unable to make a broad statement about the cost-effectiveness of these technologies. 49 Overall, the results of this review indicate that the current health-economic evidence base to support the more widespread use of WES and WGS in clinical practice is very limited. The absence of economic evaluations of WES and WGS in the literature was anticipated before this review was undertaken, in light of the novelty of these technologies.…”

Médecine personnalisée : chimère ou révolution ?

“…ciblées [19], conduisent là aussi à un jugement nuancé : si les coûts par année de vie supplémentaire gagnée restent de l'ordre de 20 000 € dans un certain nombre de cas, soit un chiffre équivalent à nombre d'innovations médicales des trente dernières années, ils peuvent souvent être multipliés par un facteur dix ou cinquante en fonction des caractéris-tiques des tests et des molécules associées et des négocia-tions de prix et de remboursement auxquelles ces innovations donnent lieu. Dans le débat général, évoqué au début de cet éditorial, qui voit s'affronter techno-optimistes et techno-pessimistes parmi les économistes, certains s'efforcent aujourd'hui de proposer un dépassement de cette opposition : plutôt que de discuter si les innovations d'aujourd'hui sont, ou non, moins porteuses de gains de productivité que celles d'hier, ne faudrait-il pas se demander si c'est le concept même de productivité, étroitement lié à la seule progression du produit intérieur brut, qui nécessite une remise en cause pour intégrer dans sa mesure d'autres composantes du bien-être et du développement humains [20].…”

Is personalized medicine a panacea for health management? Some thoughts on its desirability

“…Predictive, personalized [1], individualized [2] or stratified [3] medicine are some of the terms that have been coined to describe a new approach to dealing with disease. In essence, the new paradigm is based on matching patients with the best treatments available according to each patient's characteristics.…”

“…The specific features of evaluation processes (mainly assessing the links between tests results and final health outcomes) demand ever more complex techniques to assess the final effectiveness of the technologies under study as well as their efficiency [2]. Currently, much research is being undertaken in this area, as can be seen in the literature and in ISPOR discussion panels.…”

“…Due to the inherent uncertainty surrounding the validity of test results (false positives and false negatives) and treatment effectiveness, it still remains ambiguous if personalized medicine is the best choice for all conditions [2]. For instance, there are some reported cases of patients responding to oncology treatments in spite of being previously classified by genetic tests as not indicated to receive that particular therapy.…”