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Health Economic Evaluation in Genomics

Module description

This module is available either via blended learning with contact days on-campus, or as fully distance learning via our online platform. There may be some variation in scheduled teaching and learning activities depending on your mode of study. 

Technological advances in genomic medicine have led to new tests, such as whole genome sequencing which could provide substantial improvements in disease diagnosis and treatment effectiveness. However, the continuous growth in the use of genomic technologies also has cost implications. This module will provide you with an understanding of the methods of economic evaluation used to estimate potential costs of implementing new genomic technologies and the potential benefits to patients, the NHS and the wider economy given health care resource constraints. You will gain an overview of the different types of economic evaluations, and the challenges involved in the design, data collection, analysis and in their use to inform decision-makers on the benefits and costs associated with the introduction of genomic medicine in healthcare systems.

Module aims - intentions of the module

The UK Government is striving towards producing high quality evidence-based genomic medicine using the best available evidence on benefits and costs associated with genomic medicine. The aim of this module is to help you understand the different methods of economic evaluation, the types of data required, and provide you with the skills and understanding to critically appraise economic evaluations of genomic medicine. You will also gain an understanding of the role of economic evaluation in the prioritisation of interventions in genomic medicine.

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

On successfully completing the module you will be able to...

• 1. Critically evaluate the different types of economic evaluation used in genomic medicine
• 2. Explain how to collect health outcome, non-health outcome and cost data for an economic evaluation in genomic medicine
• 3. Interpret the results of an economic evaluation in genomic medicine
• 4. Understand the importance of a budget impact analysis in genomic medicine
• 5. Discuss how health care decision makers use health economic evidence when deciding how to prioritise health care interventions in genomic medicine

ILO: Discipline-specific skills

On successfully completing the module you will be able to...

• 6. Identify the potential value of genomic medicine in the absence of (alternative) treatment
• 7. Evaluate evidence on both the benefits and costs of current and emerging interventions in genomic medicine

ILO: Personal and key skills

On successfully completing the module you will be able to...

• 8. Critically reflect on personal practice and make connections between known and unknown areas, to allow for personal development, adaptation and change.
• 9. Respond to innovation and new technologies and be able to evaluate these in the context of best practice and the need for improved service delivery.
• 10. Communicate accurately and effectively with peers, tutors and the public.

Syllabus plan

Whilst the module's precise content may vary from year to year, an example of an overall structure is as follows:

• Definition and purpose of economic evaluation, including the concept of opportunity cost

• Types of economic evaluation analyses and studies, and their advantages and disadvantages, covering

  • Cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis, cost-minimisation analysis

  • Economic evaluations alongside a randomised controlled trial, decision-analytic models

• Different health outcome measures and their limitations – diagnostic yield, life-years saved, quality-adjusted life-years

• Collecting health outcome data, and data on benefits beyond health outcomes, including

  • Health state utility values, patient questionnaires

  • Willingness to pay and discrete choice experiments

    • Collecting cost data, for instance from

      • British National Formulary, Hospital Episode Statistics, NHS Unit Costs of Health and Social Care

    • Perspectives and discounting

    • Presenting and interpreting results of an economic evaluation, including

      • Cost-per quality-adjusted life-year and incremental cost-effectiveness ratios (ICERs)

    • Issues and challenges surrounding health economic evaluations in genomic medicine including the use of genomic technologies

    • Critical appraisal of economic evaluations

    • Structuring a model-based economic evaluation

    • Budget impact analysis – purpose, data required, analysis and interpretation

    • Decision-makers use of economic evaluations for prioritising health care interventions in genomic medicine

      • National (NICE) and local decision-makers

      • Understand how evidence from economic evaluations is presented and contributes to decision-making.

      • Barriers to the use of health economic information in the prioritisation of genomic health care interventions

Learning activities and teaching methods (given in hours of study time)

Details of learning activities and teaching methods

Formative assessment

Summative assessment (% of credit)

Details of summative assessment

Details of re-assessment (where required by referral or deferral)

Re-assessment notes

Please refer to the TQA section on Referral/Deferral: http://as.exeter.ac.uk/academic-policy-standards/tqa-manual/aph/consequenceoffailure/

Indicative learning resources - Basic reading

• Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW 2005. Methods for the Economic Evaluation of Health Care Programmes (Oxford Medical Publications)

• Caro JJ, Briggs AH, Siebert U, Kuntz KM, ISPOR-SMDM Modeling Good Research Pracices Task Force 2012 Modeling good research practices – overview: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force-1 Medical Decision Making 32(5):667-77.

• Don Husereau, Michael Drummond, Stavros Petrou, Chris Carswell, David Moher, Dan Greenberg, Federico Augustovski, Andrew H. Briggs, and others. Consolidated Health Economic Evaluation Reporting Standards (CHEERS)—Explanation and Elaboration: A Report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force. Value in Health 2013; 16 (2): 231–250

Indicative learning resources - Web based and electronic resources

• https://www.ispor.org/conferences-education/education-training/virtual/webinars

• http://www.ncbi.nlm.nih.gov/pubmed

• https://pharmacogenomics.ucsd.edu/

Key words search

Economic evaluation, health benefits, costs, decision-making