Journal Article
. 2016 Aug;6(1).
doi: 10.1186/s13561-016-0113-7.

Implementing personalized medicine with asymmetric information on prevalence rates

Fernando Antoñanzas 1 Carmelo A Juárez-Castelló 2 Roberto Rodríguez-Ibeas 2 
Affiliations
  • PMID: 27539222
  •     23 References

Abstract

Although personalized medicine is becoming the new paradigm to manage some diseases, the economics of personalized medicine have only focused on assessing the efficiency of specific treatments, lacking a theoretical framework analyzing the interactions between pharmaceutical firms and healthcare systems leading to the implementation of personalized treatments. We model the interaction between the hospitals and the manufacturer of a new treatment as an adverse selection problem where the firm does not have perfect information on the prevalence across hospitals of the genetic characteristics of the patients making them eligible to receive a new treatment. As a result of the model, hospitals with high prevalence rates benefit from the information asymmetry only when the standard treatment is inefficient when applied to the patients eligible to receive the new treatment. Otherwise, information asymmetry has no value. Personalized medicine may be fully or partially implemented depending on the proportion of high prevalence hospitals.

Keywords: Endogenous reference price; Exogenous reference price; Generic drug; Off-patent drug; Pharmaceutical expenditures.

Personalized oncology: recent advances and future challenges.
Madhu Kalia.
Metabolism, 2012 Sep 25; 62 Suppl 1. PMID: 22999010
Review.
Is individualized medicine more cost-effective? A systematic review.
Maximilian H M Hatz, Katharina Schremser, Wolf H Rogowski.
Pharmacoeconomics, 2014 Feb 28; 32(5). PMID: 24574059
Systematic Review.
Personalized medicine and the role of health economics and outcomes research: issues, applications, emerging trends, and future research.
John C O'Donnell.
Value Health, 2013 Sep 27; 16(6 Suppl). PMID: 24034305
Economic analysis of targeting chemotherapy using a 21-gene RT-PCR assay in lymph-node-negative, estrogen-receptor-positive, early-stage breast cancer.
John Hornberger, Leon E Cosler, Gary H Lyman.
Am J Manag Care, 2005 May 19; 11(5). PMID: 15898220
The faces of personalized medicine: a framework for understanding its meaning and scope.
W Ken Redekop, Deirdre Mladsi.
Value Health, 2013 Sep 27; 16(6 Suppl). PMID: 24034312
Challenges in the development and reimbursement of personalized medicine-payer and manufacturer perspectives and implications for health economics and outcomes research: a report of the ISPOR personalized medicine special interest group.
Eric Faulkner, Lieven Annemans, +12 authors, Personalized Medicine Development and Reimbursement Working Group.
Value Health, 2012 Dec 19; 15(8). PMID: 23244820
Cost-effectiveness analysis of screening for KRAS and BRAF mutations in metastatic colorectal cancer.
Ajay S Behl, Katrina A B Goddard, +4 authors, Michael V Maciosek.
J Natl Cancer Inst, 2012 Dec 01; 104(23). PMID: 23197490    Free PMC article.
KRAS mutation status is predictive of response to cetuximab therapy in colorectal cancer.
Astrid Lièvre, Jean-Baptiste Bachet, +10 authors, Pierre Laurent-Puig.
Cancer Res, 2006 Apr 19; 66(8). PMID: 16618717
Highly Cited.
Health technology assessments in personalized medicine: illustrations for cost-effectiveness analysis.
Maarten J Postma, Cornelis Boersma, +3 authors, Lieven Annemans.
Expert Rev Pharmacoecon Outcomes Res, 2011 Aug 13; 11(4). PMID: 21831013
Linking pharmacogenetics-based diagnostics and drugs for personalized medicine.
Louis P Garrison, M J Finley Austin.
Health Aff (Millwood), 2006 Sep 13; 25(5). PMID: 16966724
Reflections on market access for personalized medicine: recommendations for Europe.
Katherine Payne, Lieven Annemans.
Value Health, 2013 Sep 27; 16(6 Suppl). PMID: 24034310
Review.
Through a glass darkly: economics and personalised medicine.
Alan Haycox, Munir Pirmohamed, +2 authors, Sarah Richards.
Pharmacoeconomics, 2014 Aug 15; 32(11). PMID: 25118988
Some economics on personalized and predictive medicine.
F Antoñanzas, C A Juárez-Castelló, R Rodríguez-Ibeas.
Eur J Health Econ, 2014 Nov 09; 16(9). PMID: 25381039
Personalized medicine: factors influencing reimbursement.
Lisa M Meckley, Peter J Neumann.
Health Policy, 2009 Oct 10; 94(2). PMID: 19815307
Economic incentives for evidence generation: promoting an efficient path to personalized medicine.
Adrian Towse, Louis P Garrison.
Value Health, 2013 Sep 27; 16(6 Suppl). PMID: 24034311
Can personalized medicine survive?
W M Gibson.
Can Fam Physician, 1971 Aug 01; 17(8). PMID: 20468669    Free PMC article.
Clinical validation of the detection of KRAS and BRAF mutations from circulating tumor DNA.
Alain R Thierry, Florent Mouliere, +17 authors, Marc Ychou.
Nat Med, 2014 Mar 25; 20(4). PMID: 24658074
Highly Cited.
Current methodological issues in the economic assessment of personalized medicine.
Lieven Annemans, Ken Redekop, Katherine Payne.
Value Health, 2013 Sep 27; 16(6 Suppl). PMID: 24034308
Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer.
Soonmyung Paik, Gong Tang, +11 authors, Norman Wolmark.
J Clin Oncol, 2006 May 25; 24(23). PMID: 16720680
Highly Cited.
Genetic testing with primary prevention and moral hazard.
David Bardey, Philippe De Donder.
J Health Econ, 2013 Jun 19; 32(5). PMID: 23771050
Genetic testing in the European Union: does economic evaluation matter?
Fernando Antoñanzas, R Rodríguez-Ibeas, +3 authors, M Pinillos.
Eur J Health Econ, 2011 May 21; 13(5). PMID: 21598012
The cost-effectiveness of personalized genetic medicine: the case of genetic testing in neonatal diabetes.
Siri Atma W Greeley, Priya M John, +5 authors, Elbert S Huang.
Diabetes Care, 2011 Jan 29; 34(3). PMID: 21273495    Free PMC article.
Stratified medicine: strategic and economic implications of combining drugs and clinical biomarkers.
Mark R Trusheim, Ernst R Berndt, Frank L Douglas.
Nat Rev Drug Discov, 2007 Mar 24; 6(4). PMID: 17380152
Highly Cited. Review.