| Comparative effectiveness research and personalized medicine: catalyzing or colliding? | |
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MedLine Citation:
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PMID: 20831298 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Comparative effectiveness research (CER) is generating intense attention as interest grows in finding new and better drug technology assessment processes. The federal government is supporting the expansion of CER through funding made available in the American Recovery and Reinvestment Act of 2009 (ARRA) and by establishing the Patient-Centered Outcomes Research Institute through the Patient Protection and Affordable Care Act of 2010. At the same time, personalized medicine is generating debate about its place in clinical medicine, and so, naturally, how CER can or cannot play a role in personalized medicine is part of these debates. At the heart of the debate around the role of CER in personalized medicine is the nature of personalized medicine and how it fits within contemporary clinical research concepts. We maintain in this article that CER can serve to catalyze personalized medicine, but we recognize that, for this to happen, researchers will need to embrace new data sources and new analytic approaches. We also recognize that drug technology assessment processes will have to undergo necessary adaptations to accommodate CER as configured for personalized medicine, and that clinicians will need to be educated appropriately and provided access to decision-support systems through health information technology to use the information coming from this research. To illustrate our argument, we describe two ongoing CER studies funded and managed in the private sector evaluating personalized medicine interventions that have important clinical and financial implications. One of the studies investigates the clinical and financial effects of pharmacogenomic testing for warfarin as prescribed in conditions of typical practice settings. The other study is also set in community practice settings and compares cardiovascular outcomes of patients receiving clopidogrel who are extensive metabolizer phenotypes for the cytochrome P450 2C19 hepatic isoenzyme with all patients receiving prasugrel. |
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Authors:
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Robert S Epstein; J Russell Teagarden |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: PharmacoEconomics Volume: 28 ISSN: 1179-2027 ISO Abbreviation: Pharmacoeconomics Publication Date: 2010 |
Date Detail:
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Created Date: 2010-09-13 Completed Date: 2010-12-28 Revised Date: 2011-03-29 |
Medline Journal Info:
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Nlm Unique ID: 9212404 Medline TA: Pharmacoeconomics Country: New Zealand |
Other Details:
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Languages: eng Pagination: 905-13 Citation Subset: T |
Affiliation:
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Department of Medical and Analytical Affairs, Medco Health Solutions, Inc., Franklin Lakes, New Jersey, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Comparative Effectiveness Research* Evidence-Based Medicine Health Services Accessibility Humans Individualized Medicine* Outcome Assessment (Health Care) Technology Assessment, Biomedical / economics* United States |
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