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The Health Technology Assessment Approach of the Economic Value of Diagnostic Tests : A Literature Review

Author

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  • David Bardey

    (TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - UT - Université de Toulouse - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)

  • Philippe de Donder

    (TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - UT - Université de Toulouse - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, CNRS - Centre National de la Recherche Scientifique, UT Capitole - Université Toulouse Capitole - UT - Université de Toulouse)

  • Vera Zaporozhets

    (TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - UT - Université de Toulouse - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, UT Capitole - Université Toulouse Capitole - UT - Université de Toulouse)

Abstract

We review the medico-economic literature assessing the economic value of diagnostic and prognostic tests, with a focus on innovative and, more specifically, companion tests. Our analysis begins with a summary of systematic reviews that provide a descriptive synthesis of existing findings rather than conducting quantitative meta-analyses. These reviews reveal no consistent evidence that such tests outperform traditional approaches, such as pharmaceutical interventions. However, the cost-effectiveness of these tests, often measured in cost per QALY (Quality-Adjusted Life Year) gained, exhibits considerable heterogeneity. Notably, some genetic testing procedures may demonstrate superior performance compared to non-genetic alternatives. We then examine the economic implications of imperfect test features, exploring strategies to optimize their accuracy levels and integrating these considerations into the assessment of their economic value. Lastly, we review recent methodological and empirical studies employing these approaches, highlighting advancements in evaluating the economic impact of diagnostic and prognostic tests.

Suggested Citation

  • David Bardey & Philippe de Donder & Vera Zaporozhets, 2025. "The Health Technology Assessment Approach of the Economic Value of Diagnostic Tests : A Literature Review," Post-Print hal-05024927, HAL.
    • Handle: RePEc:hal:journl:hal-05024927
    DOI: 10.1007/s44250-025-00196-9
    Note: View the original document on HAL open archive server: https://hal.science/hal-05024927v1
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    References listed on IDEAS

    as
    1. Linda Ryen & Mikael Svensson, 2015. "The Willingness to Pay for a Quality Adjusted Life Year: A Review of the Empirical Literature," Health Economics, John Wiley & Sons, Ltd., vol. 24(10), pages 1289-1301, October.
    2. Charles E. Phelps & Alvin I. Mushlin, 1988. "Focusing Technology Assessment Using Medical Decision Theory," Medical Decision Making, , vol. 8(4), pages 279-289, December.
    3. Michael A. Kohn & Thomas B. Newman, 2001. "What White Blood Cell Count Should Prompt Antibiotic Treatment in a Febrile Child? Tutorial on the Importance of Disease Likelihood to the Interpretation of Diagnostic Tests," Medical Decision Making, , vol. 21(6), pages 479-489, December.
    4. Garber, Alan M., 2000. "Advances in cost-effectiveness analysis of health interventions," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 4, pages 181-221, Elsevier.
    5. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884, Decembrie.
    6. Alexander J. Sutton & Nicola J. Cooper & Steve Goodacre & Matthew Stevenson, 2008. "Integration of Meta-analysis and Economic Decision Modeling for Evaluating Diagnostic Tests," Medical Decision Making, , vol. 28(5), pages 650-667, September.
    7. Baker, Rachel & Chilton, Sue & Donaldson, Cam & Jones-Lee, Michael & Lancsar, Emily & Mason, Helen & Metcalf, Hugh & Pennington, Mark & Wildman, John, 2011. "Searchers vs surveyors in estimating the monetary value of a QALY: resolving a nasty dilemma for NICE," Health Economics, Policy and Law, Cambridge University Press, vol. 6(4), pages 435-447, October.
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