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How is Value Defined in Molecular Testing in Cancer? A Scoping Review

Author

Listed:
  • Alice Minhinnick

    (University of Auckland)

  • Francisco Santos-Gonzalez

    (University of Melbourne)

  • Michelle Wilson

    (University of Auckland)

  • Paula Lorgelly

    (University of Auckland)

Abstract

Objective To identify how value is defined in studies that focus on the value of molecular testing in cancer and the extent to which broadening the conceptualisation of value in healthcare has been applied in the molecular testing literature. Methods A scoping review was undertaken using Joanna Briggs Institute (JBI) guidance. Medline, Embase, EconLit and Cochrane Library were searched in August 2023. Articles were eligible if they reported costs relative to outcomes, novel costs, or novel outcomes of molecular testing in cancer. Results were synthesised and qualitative content analysis was performed with deductive and inductive frameworks. Results Ninety-one articles were included in the review. The majority (75/91) were conventional economic analyses (comparative economic evaluations and budget impact assessments) and undertaken from a healthcare system perspective (38/91). Clinical outcomes dominate the assessment of value (61/91), with quality-adjusted life-years (QALYs) the most common outcome measure (45/91). Other definitions of value were diverse (e.g. psychological impact, access to trials), inconsistent, and largely not in keeping with evolving guidance. Conclusions Broader concepts of value were not commonly described in the molecular testing literature focusing on cancer. Conventional approaches to measuring the health costs and outcomes of molecular testing in cancer prevail with little focus on non-clinical elements of value. There are emerging reports of non-clinical outcomes of testing information, particularly psychological consequences. Intrinsic attributes of the testing process and preferences of those who receive testing information may determine the realised societal value of molecular testing and highlight challenges to implementing such a value framework.

Suggested Citation

  • Alice Minhinnick & Francisco Santos-Gonzalez & Michelle Wilson & Paula Lorgelly, 2025. "How is Value Defined in Molecular Testing in Cancer? A Scoping Review," Applied Health Economics and Health Policy, Springer, vol. 23(3), pages 409-424, May.
    • Handle: RePEc:spr:aphecp:v:23:y:2025:i:3:d:10.1007_s40258-024-00901-4
    DOI: 10.1007/s40258-024-00901-4
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    1. Elizabeth J J Berm & Margot de Looff & Bob Wilffert & Cornelis Boersma & Lieven Annemans & Stefan Vegter & Job F M van Boven & Maarten J Postma, 2016. "Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-22, January.
    2. Joseph P. Cook & Joseph Golec, 2017. "How excluding some benefits from value assessment of new drugs impacts innovation," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1813-1825, December.
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