The aspirational cost of sequencing a genome is $1000, but there is little evidence to support this estimate.How much does it cost really?
Genome sequencing costs £6841 per cancer case (comprising matched tumor and germline samples) and £7050 per rare disease case (three samples). The consumables used during sequencing are the most expensive component of testing (68–72% of the total cost).Check all the details in this article . Data related to 2017. Genome cost: £3420
This paper lays out a coherent framework for the assessment of diagnostic and prognostic tests for HTA using a linked-evidence, or decision modelling, approach. It is solidly grounded on the indirect mechanism of value accrual for these health technologies that can be summarised using three interlinked components: classification (using test results to define treatment groups), choice (in terms of treatment) and outcomes. Importantly, this paper proposes a series of innovative graphical displays
aiming to better inform decision making.
The literature on the value of heterogeneity and stratified decision making directly relates to this mechanism of value accrual with diagnostic and prognostic tests. Heterogeneity is defined as the variation in outcome of a population (variability) that can at least partly be explained by some attribute of interest. Heterogeneity is valuable insofar as it allows treatment decisions to be stratified across different subgroups so as to generate gains in (net)health; but, for heterogeneity to be identified, tests need to be applied that identify the subgroup an individual patient belongs to.A reference article on the topic, for the files.
The approach developed by us is based on an outcome called years of sufficient capability (YSC). Instead of focusing on the absolute gains of capability across a population (i.e., capability maximization), the YSC targets those who fall below a threshold level of sufficient capability, with the aim being to improve capability to sufficient levels for those who are “capability poorThese are the five capabilities of most importance:
Stability— “ability to feel settled and secure”However, at the end, the same question without easy answer:
Attachment— “an ability to have love, friendship, and support”
Autonomy— “an ability to be independent”
Achievement— “an ability to achieve and progress in life”
Enjoyment— “an ability to experience enjoyment and pleasure”
How to define a sufficient threshold of capability needs to be considered further. One approach would be to conduct qualitative research using participatory methods to assign a sufficient threshold for a given population.Unfortunately the proposal of participatory methods and the measurement of capabilities is illusory, at least in my view.
| Product | Episode example | Sample conceptual focusa | Number of episodes | Clinical setting | Public episode definition | Linked risk-adjustment approach |
|---|---|---|---|---|---|---|
| 3M Patient-focused Episode Software | Not reported. | • Event-based episodes per patient • Cohort-based episodes among patients with a shared condition or characteristic | >500 | All | No | 3M Clinical Risk Groups |
| Cave Grouper | Urinary tract infection | • Physician relative efficiency and effectiveness scores • High-cost patient prediction | >500 | All | No | CCGroup MediScreen |
| CMS-BPCI | Urinary tract infection | Inpatient and post-acute care | ~50 | Inpatient, skilled nursing facility, inpatient rehabilitation facility, long-term care hospital or home health agency | Yes | No |
| McKinsey & Company | Perinatal | Principal Accountable Provider | >100 | All | Yes | Yesb |
| Optum Symmetry Episode Treatment Groups | Pregnancy, with delivery | • Patient total cost of care by condition categories • Provider profiling | >500 | All | Yes | Optum Symmetry Episode Risk Groups |
| OptumInsight Symmetry Procedure Episode Groups | Radical hysterectomy | • Medical and surgical procedure cost • Provider profiling | ~200 | All | No | Optum Symmetry Episode Risk Groups |
| Prometheus Analytics | Pregnancy | Potentially avoidable complications | ~100 | All | Yes | Prometheus Analytics risk adjustment |
| Medical Episode Grouper | Cardiac arrhythmias | • Population profiling • Provider profiling | >500 | All | No | Disease Staging and Diagnostic Cost Groups |
A weekly conversation that looks at the way technology is changing our economies, societies and daily lives. Hosted by John Thornhill, innovation editor at the Financial Times.
Prescription drug sales for 2010 through 2018 grew at a CAGR of +2.3%. This can be compared to the forecast annual CAGR of +6.9% for 2019 through 2024 with expected sales to reach $1.18trn. The growth rate for the prescription market in 2019 is forecast to be +2.0%, which depicts a decline in growth rate compared to 2018 (+5.0%). So far the industry has seen a major set-back with one of the biggest failures, aducanumab, which was discontinued in Phase 3 trials for Alzheimer’s disease.Distrust fortune tellers. Nobody knows anything about the future.
