Value-based genomic screening: exploring genomic screening for chronic diseases using triple value principles.

Dombrádi V1, Pitini E2, van El CG3, Jani A4, Cornel M3, Villari P2, Gray M4,5, Bíró K6.

Author information

1: Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
2: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
3: Department of Clinical Genetics/Amsterdam Public Health research Institute, Section Community Genetics, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
4: Value Based Healthcare Programme, Department of Primary Care, University of Oxford, Oxford, UK.
5: Oxford Centre for Triple Value Healthcare, Oxford, UK.
6: Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary. kbiro@med.unideb.hu.

Abstract

BACKGROUND:

Genomic screening has unique challenges which makes it difficult to easily implement on a wide scale. If the costs, benefits and tradeoffs of investing in genomic screening are not evaluated properly, there is a risk of wasting finite healthcare resources and also causing avoidable harm.

MAIN TEXT:

If healthcare professionals - including policy makers, payers and providers - wish to incorporate genomic screening into healthcare while minimizing waste, maximizing benefits, and considering results that matter to patients, using the principles of triple value (allocative, technical, and personal value) could help them to evaluate tough decisions and tradeoffs. Allocative value focuses on the optimal distribution of limited healthcare resources to maximize the health benefits to the entire population while also accounting for all the costs of care delivery. Technical value ensures that for any given condition, the right intervention is chosen and delivered in the right way. Various methods (e.g. ACCE, HTA, and Wilson and Jungner screening criteria) exist that can help identify appropriate genomic applications. Personal value incorporates preference based informed decision making to ensure that patients are informed about the benefits and harms of the choices available to them and to ensure they make choices based on their values and preferences.

CONCLUSIONS:

Using triple value principles can help healthcare professionals make reasoned and tough judgements about benefits and tradeoffs when they are exploring the role genomic screening for chronic diseases could play in improving the health of their patients and populations.