UCSF

TRANSPERS Publishes in Science: Should We Focus on Affordability or Value of Precision Medicine? We Need Both!

Debates about precision medicine commonly focus on whether we can “afford” it. But is that the right question? In an article published in Science, a TRANSPERS team lead by Kathryn A. Phillips with collaborators Jeroen P. Jansen and Christopher F. Weyant address this question. The article is part of a special Science report celebrating the 20th anniversary of the sequencing of the human genome.

A precision medicine intervention can generate large costs but still be a good value, or it can have a low price but provide few improvements in outcomes and be of poor value. Thus, focusing only on affordability (“Can we pay for it?”), not also value (“Should we pay for it?”), risks rejecting technologies that might make healthcare more efficient.

We assert that it is critical to examine both affordability and value but analyses of value (such as cost-effectiveness analyses) often do not examine affordability and budget impact, which can result in incomplete or contradictory conclusions. However, assessments that consider both affordability and value are beginning to become more accepted by decision-makers in the U.S. due to an increased focus - and political will - on how to ensure sustainable and efficient health care.

Precision medicine is here to stay. However, it can only achieve its potential if it is both affordable and of high value.

The full report is titled: “Complicated legacies: The human genome at 20.” We were invited to provide an economic perspective on “how we got here, and where we should (or ought not) be going.” Other papers address big data, diverse populations, data sharing, and privacy.