Valuing the outcomes associated with genome sequencing in economic evaluations

Background

In England, the National Institute for Health and Care Excellence evaluates the outcomes of new healthcare interventions using quality-adjusted life-years (QALYs). However, the weights used to generate QALYs describe quality of life in clinical terms and may not capture benefits that affect wellbeing via non-clinical routes (known as personal utility). Such benefits are often observed for complex interventions, such as programmes to prevent obesity, or interventions that facilitate personalised medicine, such as genome sequencing. 

The UK is a global leader in genome sequencing and the NHS is the first public health service to routinely offer sequencing in a national health service, via the Genomic Medicine Service. Sequencing could improve diagnosis, guide prognosis and inform treatment decisions for patients with various conditions including cancer and rare diseases. This could provide benefits that affect wellbeing via non-clinical routes, such as reassurance or access to social and educational support. However, if the current approach to generating QALYs does not capture these benefits, sequencing may be judged not cost-effective, even if it provides information that would improve patient wellbeing. 

The primary aim of this project is to evaluate existing instruments used to generate quality of life weights for use in extra-welfarist economic evaluations, in terms of their capacity to capture all impacts of genome sequencing on patient wellbeing. Such instruments will include the EQ-5D-5L, the SF-36 and ICECAP capability measures. We expect the student will: 

• Critically appraise the theoretical capacity of existing instruments to capture the impacts of genome sequencing;
• Review the current use of these instruments in this context;
• Generate new data on the use of these instruments in patients undergoing genome sequencing;
• Identify instruments that effectively value the outcomes associated with genome sequencing;
• Describe the characteristics of any new instruments that may be required.

RESEARCH EXPERIENCE, RESEARCH METHODS AND TRAINING

This project will allow the student to develop skills in genomics and economic evaluation in healthcare, and will provide experience and training in undertaking literature reviews, collecting and analysing quantitative data on health and non-health outcomes, and statistical programming. The student will work in a multi-disciplinary environment alongside clinicians and experts in population health and economics.

FIELD WORK, SECONDMENTS, INDUSTRY PLACEMENTS AND TRAINING 

Training will be offered on relevant analytical methods and to facilitate collecting and analysing outcomes data. The student will be encouraged to present their work at national/international conferences. There will be opportunities to undertake work on this project with other researchers on the Old Road Campus and in the wider Medical Sciences Division.

Prospective candidate

This project would suit an applicant with a quantitative background and an interest in economic evaluation methods. Previous experience undertaking economic evaluations in any clinical context would be advantageous.