Economics of genomic testing for women with breast cancer.

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Abstract

Background: Creating the value proposition for innovations in personalized genomic medicine requires generation of evidence-based demonstrations of clinical utility and cost-effectiveness. Objectives: To assess economic studies of genomic testing for women with breast cancer and to understand the value of genomic testing for multiple stakeholders. Study Design: Literature review. Methods: A structured review of the literature was conducted to identify and synthesize available evidence regarding economic analyses of genomic testing for breast cancer. A search was conducted using PubMed and Google Scholar for articles published between January 1, 2005, and December 31, 2010. The search was then expanded to include articles as far back as 1981. In addition, snowball methodology was used to identify and include additional articles based on frequency of author publication and frequency of citation in the literature. Results: Of the articles reviewed, a subset of 9 articles describing specific economic analysis studies were included in a more in-depth, side-by-side comparison. This review of the literature on the economics of genomic testing for women with breast cancer found that most of the economic evidence relied on modeling rather than clinical trial data. Conclusions: Facilitating the diffusion of new technology will require more data to satisfy the payer, provider, and societal perspectives. Conversely, willingness by payers and clinicians to consider economic modeling data as part of their evaluation of new technologies can help facilitate the diffusion of newly developed genomic tests.