Economics of Pharmacogenomics: Rethinking Beyond QALYs?
Katherine Payne and Alexander J. Thompson
Affiliation: Manchester Centre for Health Economics, Jean McFarlane Building, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
Pharmacogenomic technologies can potentially be beneficial to patients and healthcare providers alike.
Decision-makers allocating finite healthcare budgets require robust and timely evidence to support the cost-effectiveness
of pharmacogenomic technologies. This paper describes the use of the quality adjusted life year (QALY) to inform
decision-making drawing on the examples of National Institute for Health and Care Excellence (NICE) technology
appraisals of pharmacogenomic technologies in the UK. Importantly, the paper explains two theoretical viewpoints that
underpin the two main types of economic analysis: cost benefit analysis and cost-effectiveness analysis. The advantages
and disadvantages of QALYs are discussed together with potential options for moving beyond the QALY such as the use
of the capability approach and willingness to pay methods. However, the paper concludes that most health economists, as
providers of information for societal decision-making, are probably not yet ready to depart from the QALY to inform
resource allocation in the context of pharmacogenomic technologies.
Keywords: Cost benefit analysis, cost effectiveness analysis, decision-making, economic evaluation, QALYs, resource
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