As precision medicine advances within an already complex and costly healthcare system, it is imperative to recognise the need to reassess the way that value in medical care and health is created and accounted for. On the one hand, value is increasingly created by harnessing the synergies of technological advances and data to develop innovative diagnostics, therapeutics, and biomarkers. On the other hand, the economic value of prevention and quality of life in good health may be overlooked and must be re-evaluated in light of the cost and benefits of precision prevention and personalised health.
- Prevention. Technologies such as genomic sequencing and machine learning enable predictive diagnostics, which put more emphasis and means on prevention. While representing an initial investment, a question is whether full genome sequencing followed by more incentives for prevention could be acceptable to society (and under which conditions) and useful to improve global health. The balance between treatment and prevention in terms of investment, reimbursement and value needs to be reassessed. One question is the extent to which the actual net cost of prevention might be lower than currently accounted, which would make strategies for genetic testing-based prevention more valuable for society.
- Therapies. When fully personalized therapies are found to be the best solution for a patient, healthcare systems should ideally evolve to focus on the broader economic and societal value of the therapy, instead of a narrow focus on technology assessment and cost affordability. There is an opportunity to frame health as an investment rather than a cost (or re-orienting from transactions-driven to value-based health care provision) while also sustaining solidarity with the more vulnerable.
- Payment. Healthcare providers, payers and industry strive to make precision medicine affordable, acceptable and inclusive. Pricing and licensing around precision medicine must take into account the fact that health care systems are very resource constrained. A possible solution is to shift to ‘value-based health care’, which has a more holistic approach to the pricing for drugs and treatments. In summary, it considers the total cost of illness over the life of a patient. In value-based healthcare, drugs and treatments would be priced in relation to the benefit, or added value, that they deliver to society.
On 4-6 December 2019, Health 2030 and IRGC organised a workshop with the Brocher Foundation, to discuss mechanisms for value creation, whereby investments in precision medicine can be capitalised for the benefit of patients and society.