- Prof Dyfrig Hughes
CV
Dyfrig Hughes is professor of pharmacoeconomics at Bangor University, Wales, where he directs the Pharmaceutical Economics, Policy and Prescribing Research group. He has published extensively on research concerning the safe, effective and efficient use of medicines. This has included a series of economic evaluations of pharmacogenomic tests relating to treatment with abacavir, allopurinol, carbamazepine, clopidogrel, fluoropyrimidines, irinotecan, and warfarin; as well as multi-gene panels. Dyfrig is part of the UK’s Pharmacogenomics Centre of Excellence for Regulatory Science and Innovation; is vice-chair of the All Wales Medicines Strategy Group (which is the statutory body that advises the Welsh Minister on strategic developments in medicines management and prescribing); chairs the National Pharmacogenomics Group for the National Health Service in Wales (responsible for the implementation of pharmacogenomics); and co-chairs NHS England’s Pharmacogenomics Test Evaluation Working Group (advising on the National Genomics Test Directory).
ABSTRACT
Pharmacogenetic tests are being promoted and used increasingly to prevent adverse drug reactions and improve the efficacy of treatments. However, payers of healthcare often require evidence on the cost-effectiveness of testing to justify and support widespread clinical implementation. Cost-effectiveness does not imply cost-saving—indeed, economic evaluations have dispelled a perception that precision medicine, achieved through pharmacogenetic testing, reduces healthcare costs. For many tests aimed at preventing adverse drug reactions, cost-effectiveness analyses predict modest improvements in health benefits and increases in total costs. While there are many uncertainties in estimating the value of testing, factors that influence cost-effectiveness include the rarity of the outcome, the effectiveness and safety of alternative treatments, and the scope and perspective of analysis. Drawing from a range of examples, this presentation will illustrate how cost-effectiveness estimates are sensitive to such factors, describe the analytical challenges of assessing the value of pharmacogenomic panel testing, and discuss whether and how broader societal impacts should be considered when evaluating pharmacogenomic testing services.