Evidence map›Paper›PMID 24574059›Full record

SynthesisPharmacoEconomics2014

Is individualized medicine more cost-effective? A systematic review.

Maximilian H M Hatz, Katharina Schremser, Wolf H Rogowski

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in PharmacoEconomics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Are whole-exome and whole-genome sequencing approaches cost-effective? A systematic review of the literature.Genetics in medicine : official journal of the American College of Medical Genetics · 2018
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Short-term costs of integrating whole-genome sequencing into primary care and cardiology settings: a pilot randomized trial.Genetics in medicine : official journal of the American College of Medical Genetics · 2018
    Trial
  7. Article
  8. Review
  9. Economics and Precision Medicine.Handbook of experimental pharmacology · 2023
    Article
  10. Article
  11. Warfarin resistance: possibilities to solve this problem. A case report.The Journal of international medical research · 2022
    Article
  12. Review
  13. Review
  14. Article
  15. Article
  16. Cost-effectiveness of precision medicine: a scoping review.International journal of public health · 2019
    Article
  17. Article
  18. Article
  19. Precision Medicine: From Science To Value.Health affairs (Project Hope) · 2018
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Maximilian H M HatzHamburg Center for Health Economics, University of Hamburg, 20354, Hamburg, Germany, Maximilian.Hatz@uni-hamburg.de.
Katharina Schremser
Wolf H Rogowski

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIndividualized 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.

objectiveOur 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

methodCost-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.

resultsMost 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.

conclusionsIM 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.

Indexed as

Health Care CostsCost-Benefit AnalysisEconomics, MedicalHumansPrecision MedicineQuality-Adjusted Life Years

Identifiers

PMID24574059

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.