Economics of Pharmacogenomics: Rethinking Beyond QALYs?

Pharmacogenomic technologies can potentially be beneficial to patients and healthcare providers alike. Decision-makers allocating finite healthcare budgets require robust and timely evidence to support the cost-effectiveness of pharmacogenomic technologies. This paper describes the use of the quality adjusted life year (QALY) to inform decision-making drawing on the examples of National Institute for Health and Care Excellence (NICE) technology appraisals of pharmacogenomic technologies in the UK. Importantly, the paper explains two theoretical viewpoints that underpin the two main types of economic analysis: cost benefit analysis and cost-effectiveness analysis. The advantages and disadvantages of QALYs are discussed together with potential options for moving beyond the QALY such as the use of the capability approach and willingness to pay methods. However, the paper concludes that most health economists, as providers of information for societal decision-making, are probably not yet ready to depart from the QALY to inform resource allocation in the context of pharmacogenomic technologies.