Demand for Precision Medicine: A Discrete-Choice Experiment and External Validation Study.
Background: A limited evidence base and lack of clear clinical guidelines challenge healthcare systems' adoption of precision medicine. The effect of these conditions on demand is not understood.Objective: This research estimated the public's preferences and demand for precision medicine outcomes.Me...
| Publicado en: | PharmacoEconomics Vol. 38; no. 1; pp. 57 - 69 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jan2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141210442&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141210442 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11707690 C5G jtl: PharmacoEconomics issn: 11707690 maglogo: N pubinfo: dt: Jan2020 vid: 38 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 141210442 141210442 NLM31489595 141210442 10.1007/s40273-019-00834-0 NLM31489595 141210442 ppf: 57 ppct: 12 formats: tig: atl: Demand for Precision Medicine: A Discrete-Choice Experiment and External Validation Study. aug: au: Regier, Dean A. Veenstra, David L. Basu, Anirban Carlson, Josh J. affil: Cancer Control Research - Canadian Centre for Applied Research in Cancer Control (ARCC), BC Cancer, 675 West 10th Avenue, V5Z 1L3, Vancouver, British Columbia, Canada sug: subj: Uncertainty Decision Making Patient Satisfaction Economics Models, Theoretical Adult Middle Age Young Adult Male Patient Satisfaction Statistics and Numerical Data Female United States Adolescence Funding Source Human Adult: 19-44 years Middle Aged: 45-64 years Adolescent: 13-18 years Male Female ab: Background: A limited evidence base and lack of clear clinical guidelines challenge healthcare systems' adoption of precision medicine. The effect of these conditions on demand is not understood.Objective: This research estimated the public's preferences and demand for precision medicine outcomes.Methods: A discrete-choice experiment survey was conducted with an online sample of the US public who had recent healthcare experience. Statistical analysis was undertaken using an error components mixed logit model. The responsiveness of demand in the context of a changing evidence base was estimated through the price elasticity of demand. External validation was examined using real-world demand for the 21-gene recurrence score assay for breast cancer.Results: In total, 1124 (of 1849) individuals completed the web-based survey. The most important outcomes were survival gains with statistical uncertainty, cost of testing, and medical expert agreement on changing care based on test results. The value ($US, year 2017 values) for a test where most (vs. few) experts agreed to changing treatment based on test results was $US1100 (95% confidence interval [CI] 916-1286). Respondents were willing to pay $US265 (95% CI 46-486) for a test that could result in greater certainty around life-expectancy gains. The predicted demand of the assay was 9% in 2005 and 66% in 2014, compared with real-world uptake of 7% and 71% (root-mean-square prediction error 0.11). Demand was sensitive to price (1% increase in price resulted in > 1% change in demand) when first introduced and insensitive to price (1% increase in price resulted in < 0.1% change in demand) as the evidence base became established.Conclusions: Evidence of external validity was found. Demand was weak and responsive to price in the near term because of uncertainty and an immature evidence base. Clear communication of precision medicine outcomes and uncertainty is crucial in allowing healthcare to align with individual preferences. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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