Cost-Effectiveness Analysis in Public Health Genomics and Precision Health: Recent Findings, Methodologic Issues, and the Path Forward
October 26, 2023, 11:00 am – 12:00 pm ET
David Veenstra, PhD
Professor
CHOICE Faculty, Department of Pharmacy, Pharmacogenomics Research Network, Pharmacy Faculty, School Faculty, University of Washington, Seattle
Dr. Veenstra is a professor in the Department of Pharmacy and the Comparative Health Outcomes, Policy & Economics (CHOICE) Institute at the University of Washington. He graduated from the University of California, San Francisco with doctoral degrees in clinical pharmacy and computational chemistry. He conducted his postdoctoral training in health economics and outcomes research with the University of Washington, including a 1-year externship with Roche Global Pharmacoeconomics. Dr. Veenstra’s primary research interests are the clinical, economic, and policy implications of using genomic information in health care. His major research projects include evaluation of the cost-effectiveness of population-level genomic screening, pharmacogenomics in diverse populations, decision modeling techniques to assess evidence thresholds, and stakeholder preferences for precision medicine. Dr. Veenstra’s research has been funded through grants from the National Human Genome Research Institute, Centers for Disease Control and Prevention, National Cancer Institute, and the National Institute for General Medical Sciences. Dr. Veenstra has worked extensively with organizations such as the Academy of Managed Care Pharmacy (AMCP) and the Institute for Clinical and Economic Review (ICER) to further the practical application of cost-effectiveness analysis in managed care decision-making. Dr. Veenstra teaches courses in pharmacoeconomics and managed care and is an author or co-author of five book chapters and more than 200 peer-reviewed publications.
Selected References
Population Screening
- Population genomic screening for three common hereditary conditions : a cost-effectiveness analysis.
Guzauskas GF, Garbett S, Zhou Z, Schildcrout JS, Graves JA, Williams MS, Hao J, Jones LK, Spencer SJ, Jiang S, Veenstra DL, Peterson JF. Ann Intern Med. 2023 May 9;176(5):785-795. doi: 10.7326/M22-0846. Epub 2023 May 9. - Cost-effectiveness of population-wide genomic screening for familial hypercholesterolemia in the United States.
Spencer SJ, Jones LK, Guzauskas GF, Hao J, Williams MS, Peterson JF, Veenstra DL. J Clin Lipidol. 2022 Sep-Oct;16(5):667-675. doi: 10.1016/j.jacl.2022.07.014. Epub 2022 Jul 30.
- Cost-effectiveness of population-wide genomic screening for Lynch syndrome in the United States.
Guzauskas GF, Jiang S, Garbett S, Zhou Z, Spencer SJ, Snyder SR, Graves JA, Williams MS, Hao J, Peterson JF, Veenstra DL. Genet Med. 2022 May;24(5):1017-1026. doi: 10.1016/j.gim.2022.01.017. Epub 2022 Feb 25. - Cost-effectiveness of population-wide genomic screening for hereditary breast and ovarian cancer in the United States.
Guzauskas GF, Garbett S, Zhou Z, Spencer SJ, Smith HS, Hao J, Hassen D, Snyder SR, Graves JA, Peterson JF, Williams MS, Veenstra DL. JAMA Netw Open. 2020 Oct 1;3(10):e2022874. doi: 10.1001/jamanetworkopen.2020.22874. - Cost-effectiveness of population genomic screening.
Veenstra DL, Guzauskas G, Peterson J, Hassen DA, Snyder S, Hao J, Williams M. Genet Med. 2019 Dec;21(12):2840-2841. doi: 10.1038/s41436-019-0580-4.
Diagnosis of Genetic Diseases
- Cost-effectiveness frameworks for comparing genome and exome sequencing versus conventional diagnostic pathways: A scoping review and recommended methods.
Ferket BS, Baldwin Z, Murali P, Pai A, Mittendorf KF, Russell HV, Chen F, Lynch FL, Lich KH, Hindorff LA, Savich R, Slavotinek A, Smith HS, Gelb BD, Veenstra DL .Genet Med. 2022 Oct;24(10):2014-2027. doi: 10.1016/j.gim.2022.06.004. Epub 2022 Jul 14. - Economic value of exome sequencing for suspected monogenic disorders.
Ferket BS, Veenstra DL. Genet Med. 2020 Nov;22(11):1909. doi: 10.1038/s41436-020-0888-0. Epub 2020 Jun 30.
Non-Genomic Precision Health
- A framework for using real-world data and health outcomes modeling to evaluate machine learning-based risk prediction models.
Rodriguez PJ, Veenstra DL, Heagerty PJ, Goss CH, Ramos KJ, Bansal A. Value Health. 2022 Mar;25(3):350-358. doi: 10.1016/j.jval.2021.11.1360. Epub 2021 Dec 22. - Assessing the economic value of clinical artificial intelligence: challenges and opportunities.
Hendrix N, Veenstra DL, Cheng M, Anderson NC, Verguet S. Value Health. 2022 Mar;25(3):331-339. doi: 10.1016/j.jval.2021.08.015. Epub 2021 Oct 9.
Pharmacogenomics
- Are there different evidence thresholds for genomic versus clinical precision medicine? A value of information-based framework applied to antiplatelet drug therapy.
Guzauskas GF, Basu A, Carlson JJ, Veenstra DL. Value Health. 2019 Sep;22(9):988-994. doi: 10.1016/j.jval.2019.03.023. Epub 2019 Aug 1.
- Are evidence standards different for genomic- vs. clinical-based precision medicine? A quantitative analysis of individualized warfarin therapy.
Dhanda DS, Guzauskas GF, Carlson JJ, Basu A, Veenstra DL. Clin Pharmacol Ther. 2017 Nov;102(5):805-814. doi: 10.1002/cpt.663. Epub 2017 Jul 10. - The value of routine pharmacogenomic screening-Are we there yet? A perspective on the costs and benefits of routine screening—shouldn’t everyone have this done?
Veenstra DL. Clin Pharmacol Ther. 2016 Feb;99(2):164-166. doi: 10.1002/cpt.299. Epub 2015 Dec 23.
General/Methodology
- Conceptualization of utility in translational clinical genomics research.
Smith HS, Brothers KB, Knight SJ, Ackerman SL, Rini C, Veenstra DL, McGuire AL, Wilfond BS, Malek J. Am J Hum Genet. 2021 Nov 4;108(11):2027-2036. doi: 10.1016/j.ajhg.2021.08.013. Epub 2021 Oct 22. - Reimbursement for genetic variant reinterpretation: five questions payers should ask.
Veenstra DL, Rowe JW, Pagán JA, Brown HS, Schneider JE, Gupta A, Berger SM, Chung WK, Appelbaum PS. Am J Manag Care. 2021 Oct 1;27(10):e336-e338. doi: 10.37765/ajmc.2021.88763.
- Payer preferences and willingness to pay for genomic precision medicine: a discrete choice experiment.
Dhanda DS, Veenstra DL, Regier DA, Basu A, Carlson JJ. J Manag Care Spec Pharm. 2020 Apr;26(4):529-537. doi: 10.18553/jmcp.2020.26.4.529.
Hosted by
- Public Health Genomics Branch in the Division of Blood Disorders and Public Health Genomics, Centers for Disease Control and Prevention
- Precision Public Health Network