PharmacoEconomics

, Volume 32, Issue 5, pp 443–455

Is Individualized Medicine More Cost-Effective? A Systematic Review

Authors

    • Hamburg Center for Health EconomicsUniversity of Hamburg
    • Institute for Health Economics and Health Care Management Helmholtz Zentrum München (GmbH)-German Research Center for Environmental Health
  • Katharina Schremser
    • Institute for Health Economics and Health Care Management Helmholtz Zentrum München (GmbH)-German Research Center for Environmental Health
  • Wolf H. Rogowski
    • Institute for Health Economics and Health Care Management Helmholtz Zentrum München (GmbH)-German Research Center for Environmental Health
    • Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical CenterLudwig Maximilians University
Systematic Review

DOI: 10.1007/s40273-014-0143-0

Cite this article as:
Hatz, M.H.M., Schremser, K. & Rogowski, W.H. PharmacoEconomics (2014) 32: 443. doi:10.1007/s40273-014-0143-0

Abstract

Background

Individualized medicine (IM) is a rapidly evolving field that is associated with both visions of more effective care at lower costs and fears of highly priced, low-value interventions. It is unclear which view is supported by the current evidence.

Objective

Our objective was to systematically review the health economic evidence related to IM and to derive general statements on its cost-effectiveness.

Data sources

A literature search of MEDLINE database for English- and German-language studies was conducted.

Study appraisal and synthesis method

Cost-effectiveness and cost-utility studies for technologies meeting the MEDLINE medical subject headings (MeSH) definition of IM (genetically targeted interventions) were reviewed. This was followed by a standardized extraction of general study characteristics and cost-effectiveness results.

Results

Most of the 84 studies included in the synthesis were from the USA (n = 43, 51 %), cost-utility studies (n = 66, 79 %), and published since 2005 (n = 60, 71 %). The results ranged from dominant to dominated. The median value (cost-utility studies) was calculated to be rounded $US22,000 per quality-adjusted life year (QALY) gained (adjusted to $US, year 2008 values), which is equal to the rounded median cost-effectiveness in the peer-reviewed English-language literature according to a recent review. Many studies reported more than one strategy of IM with highly varying cost-effectiveness ratios. Generally, results differed according to test type, and tests for disease prognosis or screening appeared to be more favorable than tests to stratify patients by response or by risk of adverse effects. However, these results were not significant.

Limitations

Different definitions of IM could have been used. Quality assessment of the studies was restricted to analyzing transparency.

Conclusions

IM neither seems to display superior cost-effectiveness than other types of medical interventions nor to be economically inferior. Instead, rather than ‘whether’ healthcare was individualized, the question of ‘how’ it was individualized was of economic relevance.

Supplementary material

40273_2014_143_MOESM1_ESM.pdf (397 kb)
Supplementary material 1 (PDF 397 kb)

Copyright information

© Springer International Publishing Switzerland 2014