Scottish Longitudinal Study
Development & Support Unit
Estimating the value of Precision Medicine Technologies: Developing a Scottish Toolkit
Dr Claudia Geue (University of Glasgow)
Dr Jim Lewsey (University of Glasgow)
The potential that personalised and precision medicine (PPM) can have for improving health outcomes depends on being able to correctly estimate disease burden. The objective of our proposed study is to develop a toolkit to support the estimation of the potential value of precision medicine technologies and better targeting of research efforts. The toolkit will comprise the following research aims: 1. An estimation of the economic and health impact of a range of diseases within Scotland 2. A mapping of the viability and potential value of range of precision medicine technologies 3. A review of the Scottish precision medicine evidence ecosystem.
Dzau and colleagues  highlighted the potential that personalised and precision medicine (PPM) had for improving health outcomes through prevention but that incentives were not always aligned to translate this into practice. Doble et al  argued in reply that it was unrealistic to aim for 10-50% reduction in incidence of major complex diseases given that a Cochrane review  had shown no evidence of behavioural change after provision of genetic information. Doble et al called for genomic testing to be prioritised to identify individuals at ‘high risk of imminent, serious, preventable, penetrant disorders that have large health care costs’ as these gains would be immediate . However, these claims and the potential that PPM can offer rely on the ability to correctly estimate disease burden. In 2015, Public Health Information for Scotland (ScotPHO) estimated the burden of 132 diseases, however their use of disability adjusted life years (DALYs) to measure disease burden is methodologically controversial . We therefore suggest to estimate the burden of major disease categories in Scotland including: i) the financial cost to the health and social care system, and ii) the health burden in terms of quality adjusted life years (QALYs) lost. These estimates can be used to add value to estimating the potential of PPM interventions at a population level. Our approach will offer a more accurate estimation of disease burden, showing the potential for its application to PPM interventions.
Our research aim is two-fold. Initially, we will identify the burden of major diseases in Scotland and for those with the greatest burden on society we will estimate the associated financial consequences and health impacts using Scottish population level data. In a second step we will utilise these estimates to illustrate their application, predicting the impact of selected PPM interventions on disease burden.
 Dzau VJ et al. Aligning incentives to fulfil the promise of personalised medicine. Lancet 2015; 385: 2118–19.
 Doble B, Schofield DJ, Roscioli T, Mattick JS. Prioritising the application of genomic medicine. npj Genomic Med [Internet]. 2017;2(1):35. Available from: http://www.nature.com/articles/s41525-017-0037-0
 Cochrane Review
 Public Health Information for Scotland. The Scottish Burden of Disease Study, 2015, NHS Health Scotland
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