Evidence map›Paper›PMID 40339643›Full record

ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2025

Distributional Cost-Effectiveness Analysis in Genomic Medicine: Considerations for Addressing Health Equity.

Hadley Stevens Smith, James Buchanan, Ilias Goranitis, Maarten J IJzerman, Tara A Lavelle, Deborah A Marshall, Dean A Regier, Wendy J Ungar, Deirdre Weymann, Sarah Wordsworth and 2 more

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In one paragraph

Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. 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

12 authors.

Hadley Stevens SmithDepartment of Population Medicine, Harvard Medical School, Boston, MA, USA; Center for Bioethics, Harvard Medical School, Boston, MA, USA. Electronic address: hadley_smith@hphci.harvard.edu.
James BuchananHealth Economics and Policy Research Unit, Center for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, England, UK; National Institute for Health Research, Barts Biomedical Research Center, Queen Mary University of London, London, England, UK.
Ilias GoranitisEconomics of Genomics and Precision Medicine Unit, Center for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Australian Genomics, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Maarten J IJzermanUniversity of Melbourne Center for Cancer Research, Melbourne, VIC, Australia; Erasmus School of Health Policy and Management, Rotterdam, The Netherlands.
Tara A LavelleCenter for the Evaluation of Value and Risk and Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
Deborah A MarshallCumming School of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
Dean A RegierCancer Control Research, BC Cancer Research Institute, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Wendy J UngarProgram of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada.
Deirdre WeymannCancer Control Research, BC Cancer Research Institute, Vancouver, British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
Sarah WordsworthHealth Economics Research Center, Nuffield Department of Population Health and NIHR Biomedical Research Center, University of Oxford, Oxford, England, UK.
Kathryn A PhillipsCenter for Translational and Policy Research on Precision Medicine (TRANSPERS), Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA, USA.
Jeroen P JansenCenter for Translational and Policy Research on Precision Medicine (TRANSPERS), Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA, USA.

Funding

BUILDING THE EVIDENCE BASE FOR APPROPRIATE AND EFFICIENT IMPLEMENTATION OF EMERGING GENOMIC TESTS FOR DISEASE MANAGEMENT AND SCREENINGR01HG011792 · NHGRI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI PHILLIPS, KATHRYN A · 2021 to 2025
$4.6M
NHGRI NIH HHS R01 HG011792
6 · The paper itself

Abstract

objectivesDistributional cost-effectiveness analysis (DCEA) supports equitable resource allocation by quantifying equity-efficiency trade-offs. DCEA may be particularly useful to understand equity impacts in the context of genomic medicine, a rapidly growing clinical area that has prompted concerns about its potential to exacerbate health inequities by differentially benefitting some population groups over others because of disparities in research inclusion and access to specialty care. This article critically examines the application of DCEA in the context of genomic medicine.

methodsWe articulate steps for distributional impact assessment in the context of genomic medicine by adapting an existing conceptual framework for understanding the causal pathway between a healthcare intervention and the distribution of costs and effects among social groups, the inequality staircase. We discuss related data equity considerations and evidence requirements specific to genomic medicine interventions.

resultsThe need for and receipt of a genomic medicine intervention, as well as an intervention's short-term and long-term effects, may vary across equity-relevant subgroups. Research to enhance the relevance of DCEA in genomic medicine should avoid conflation of biological and social factors, empower populations that are underrepresented in genomics research, accurately assess variation in outcomes across equity-relevant subgroups, and develop methods for incorporation of nonhealth outcomes within a DCEA framework.

conclusionsBest practice-aligned applications of DCEA may facilitate transparent discussions of health equity in coverage and implementation decisions. This article provides guidance to researchers on the use of DCEA in genomic medicine and other clinical areas with similarly complex considerations around equity.

Indexed as

Cost-Benefit AnalysisGenomicsHealth EquityCost-Effectiveness AnalysisHealthcare DisparitiesHumansdistributionalequityequity-efficiency trade-offsgenomic medicineprecision medicine

Identifiers

PMID40339643
PMCPMC12317834

What OpenQuestion holds

Textmetadata
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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.