Value of Personalized Value of Personalized Medicine: Medicine: What is it? What is it? How to measure it? How to measure it? Why care? Why care? Kathryn A. Phillips, PhD Professor of Health Economics & Health Services Research Director & Principal Investigator Center for Translational & Center for Translational & Policy Research on Policy Research on Personalized Medicine Personalized Medicine (TRANSPERS) (TRANSPERS) e
Kathryn Phillips, PhD presents "Value of Personalized Health Care: What is it? How to measure it? Why Care" at the 2009 Personalized Health Care National Conference at Ohio State University.
Dr. Phillips is Professor of Health Economics and Health Services Research and director/founder of the Center for Translational and Policy Research on Personalized Medicine at the University of California San Francisco.
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Value of Personalized Medicine:Value of Personalized Medicine:What is it?What is it?
How to measure it?How to measure it?Why care?Why care?
Kathryn A. Phillips, PhDProfessor of Health Economics & Health
Services Research
Director & Principal Investigator Center for Translational & Policy Research Center for Translational & Policy Research
on Personalized Medicine (TRANSPERS)on Personalized Medicine (TRANSPERS)
University of California, San Francisco
e
What have we learned about adoption of personalized medicine?
• Value• Evidence
What needs to occur for personalized medicine to be adopted?
• Value• Evidence
Key Challenges for Personalized Medicine
1. Aligning Incentives for Maximal Benefit & Efficiency
Clinical Practice Patterns and Cost-Effectiveness of HER2 Testing Strategies in Breast Cancer Patients. Phillips KA, Marshall DA, Haas JS, Elkin EB, Liang SY, Hassett MJ, Ferrusi I, Brock JE, Van Bebber SL , 2009
– ~ 30% of breast cancer patients overexpress HER2/neu and can benefit from Herceptin• Testing is required to determine who can
benefit
– Herceptin a clinical success – but gaps remain in translation
Oldest Example of Personalized Medicine Portends Promises &
Challenges
Evidence Gap: Who Tested?
• NO data on uninsured, Medicaid recipients, or minorities
• 2/3 of eligible Medicare patients had no documentation of testing in claims records
Implementation Gap: Accuracy?
• Substantial percentage of HER2 tests performed by community laboratories are inaccurate
• 20% inaccurate based on comparison to central labs
Translation Gap: Treatment?
-Patients may receive Herceptin despite test results
• Large health plan data: up to 20% of patients
Economic Gap: Efficiency?
• No analyses of most efficient testing strategies