Mapping the value for money of precision medicine : a systematic literature review and meta-analysis

Chen, Wenjia; Wong, Chong Boon Nigel; Wang, Yi; Zemlyanska, Yaroslava; Butani, Dimple; Virabhak, Suchin; Matchar, David Bruce; Prapinvanich, Thittaya; Teerawattananon, Yot

doi:10.3389/fpubh.2023.1151504

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-30031

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Mapping the value for money of precision medicine : a systematic literature review and meta-analysis
Authors:	Chen, Wenjia Wong, Chong Boon Nigel Wang, Yi Zemlyanska, Yaroslava Butani, Dimple Virabhak, Suchin Matchar, David Bruce Prapinvanich, Thittaya Teerawattananon, Yot
et. al:	No
DOI:	10.3389/fpubh.2023.1151504 10.21256/zhaw-30031
Published in:	Frontiers in Public Health
Volume(Issue):	11
Issue:	1151504
Issue Date:	24-Nov-2023
Publisher / Ed. Institution:	Frontiers Research Foundation
ISSN:	2296-2565
Language:	English
Subjects:	Precision medicine; Medical genetics; Economic evaluation; Value for money; Systematic review; Meta-analysis; Cost effectiveness
Subject (DDC):	362.1041: Health economics
Abstract:	Objective: This study aimed to quantify heterogeneity in the value for money of precision medicine (PM) by application types across contexts and conditions and to quantify sources of heterogeneity to areas of particular promises or concerns as the field of PM moves forward. Methods: A systemic search was performed in Embase, Medline, EconLit, and CRD databases for studies published between 2011 and 2021 on cost-effectiveness analysis (CEA) of PM interventions. Based on a willingness-to-pay threshold of one-time GDP per capita of each study country, the net monetary benefit (NMB) of PM was pooled using random-effects meta-analyses. Sources of heterogeneity and study biases were examined using random-effects meta-regressions, jackknife sensitivity analysis, and the biases in economic studies checklist. Results: Among the 275 unique CEAs of PM, publicly sponsored studies found neither genetic testing nor gene therapy cost-effective in general, which was contradictory to studies funded by commercial entities and early stage evaluations. Evidence of PM being cost-effective was concentrated in a genetic test for screening, diagnosis, or as companion diagnostics (pooled NMBs, $48,152, $8,869, $5,693, p < 0.001), in the form of multigene panel testing (pooled NMBs = $31,026, p < 0.001), which only applied to a few disease areas such as cancer and high-income countries. Incremental effectiveness was an essential value driver for varied genetic tests but not gene therapy. Conclusion: Precision medicine’s value for money across application types and contexts was difficult to conclude from published studies, which might be subject to systematic bias. The conducting and reporting of CEA of PM should be locally based and standardized for meaningful comparisons.
URI:	https://digitalcollection.zhaw.ch/handle/11475/30031
Fulltext version:	Published version
License (according to publishing contract):	CC BY 4.0: Attribution 4.0 International
Departement:	School of Management and Law
Organisational Unit:	Winterthur Institute of Health Economics (WIG)
Appears in collections:	Publikationen School of Management and Law

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Chen, W., Wong, C. B. N., Wang, Y., Zemlyanska, Y., Butani, D., Virabhak, S., Matchar, D. B., Prapinvanich, T., & Teerawattananon, Y. (2023). Mapping the value for money of precision medicine : a systematic literature review and meta-analysis. Frontiers in Public Health, 11(1151504). https://doi.org/10.3389/fpubh.2023.1151504

Chen, W. et al. (2023) ‘Mapping the value for money of precision medicine : a systematic literature review and meta-analysis’, Frontiers in Public Health, 11(1151504). Available at: https://doi.org/10.3389/fpubh.2023.1151504.

W. Chen et al., “Mapping the value for money of precision medicine : a systematic literature review and meta-analysis,” Frontiers in Public Health, vol. 11, no. 1151504, Nov. 2023, doi: 10.3389/fpubh.2023.1151504.

CHEN, Wenjia, Chong Boon Nigel WONG, Yi WANG, Yaroslava ZEMLYANSKA, Dimple BUTANI, Suchin VIRABHAK, David Bruce MATCHAR, Thittaya PRAPINVANICH und Yot TEERAWATTANANON, 2023. Mapping the value for money of precision medicine : a systematic literature review and meta-analysis. Frontiers in Public Health. 24 November 2023. Bd. 11, Nr. 1151504. DOI 10.3389/fpubh.2023.1151504

Chen, Wenjia, Chong Boon Nigel Wong, Yi Wang, Yaroslava Zemlyanska, Dimple Butani, Suchin Virabhak, David Bruce Matchar, Thittaya Prapinvanich, and Yot Teerawattananon. 2023. “Mapping the Value for Money of Precision Medicine : A Systematic Literature Review and Meta-Analysis.” Frontiers in Public Health 11 (1151504). https://doi.org/10.3389/fpubh.2023.1151504.

Chen, Wenjia, et al. “Mapping the Value for Money of Precision Medicine : A Systematic Literature Review and Meta-Analysis.” Frontiers in Public Health, vol. 11, no. 1151504, Nov. 2023, https://doi.org/10.3389/fpubh.2023.1151504.