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Personalized Medicine and Genomics: Challenges and Opportunities in Assessing Effectiveness, Cost-Effectiveness, and Future Research Priorities

Author

Listed:
  • Rena Conti

    (Department of Pediatrics and Center for Health and the Social Sciences, University of Chicago, Chicago, Illinois)

  • David L. Veenstra

    (Department of Pharmacy, University of Washington, Seattle)

  • Katrina Armstrong

    (Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia)

  • Lawrence J. Lesko

    (Office of Clinical Pharmacology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland)

  • Scott D. Grosse

    (National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, SGrosse@cdc.gov)

Abstract

Personalized medicine is health care that tailors interventions to individual variation in risk and treatment response. Although medicine has long strived to achieve this goal, advances in genomics promise to facilitate this process. Relevant to present-day practice is the use of genomic information to classify individuals according to disease susceptibility or expected responsiveness to a pharmacologic treatment and to provide targeted interventions. A symposium at the annual meeting of the Society for Medical Decision Making on 23 October 2007 highlighted the challenges and opportunities posed in translating advances in molecular medicine into clinical practice. A panel of US experts in medical practice, regulatory policy, technology assessment, and the financing and organization of medical innovation was asked to discuss the current state of practice and research on personalized medicine as it relates to their own field. This article reports on the issues raised, discusses potential approaches to meet these challenges, and proposes directions for future work. The case of genetic testing to inform dosing with warfarin, an anticoagulant, is used to illustrate differing perspectives on evidence and decision making for personalized medicine.

Suggested Citation

  • Rena Conti & David L. Veenstra & Katrina Armstrong & Lawrence J. Lesko & Scott D. Grosse, 2010. "Personalized Medicine and Genomics: Challenges and Opportunities in Assessing Effectiveness, Cost-Effectiveness, and Future Research Priorities," Medical Decision Making, , vol. 30(3), pages 328-340, May.
    • Handle: RePEc:sae:medema:v:30:y:2010:i:3:p:328-340
    DOI: 10.1177/0272989X09347014
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    Citations

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    Cited by:

    1. Degtiar, Irina, 2017. "A review of international coverage and pricing strategies for personalized medicine and orphan drugs," Health Policy, Elsevier, vol. 121(12), pages 1240-1248.
    2. Qi Cao & Erik Buskens & Hans L. Hillege & Tiny Jaarsma & Maarten Postma & Douwe Postmus, 2019. "Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 475-482, April.
    3. Miriam Kasztura & Aude Richard & Nefti-Eboni Bempong & Dejan Loncar & Antoine Flahault, 2019. "Cost-effectiveness of precision medicine: a scoping review," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(9), pages 1261-1271, December.
    4. Kerr, Anne & Hill, Rosemary L. & Till, Christopher, 2018. "The limits of responsible innovation: Exploring care, vulnerability and precision medicine," Technology in Society, Elsevier, vol. 52(C), pages 24-31.

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