With current technological advancements permitting healthcare to progressively be focused towards precise patients and subcategories, the medical model now used is precision medicine. In general, this procedure includes the aspects of modifying the patient’s treatment pathway on the basis of prognosis, disease risk or response to treatment where the process shows the advantages to patients and extensive healthcare system. Precision is learned by tools incorporating information of lifestyle and environment, genetic and extends from risk equations to genetic testing.

Technological development in precision medicine is anticipated to continue, organized by programmes like Precis

With current technological advancements permitting healthcare to progressively be focused towards precise patients and subcategories, the medical model now used is precision medicine. In general, this procedure includes the aspects of modifying the patient’s treatment pathway on the basis of prognosis, disease risk or response to treatment where the process shows the advantages to patients and extensive healthcare system. Precision is learned by tools incorporating information of lifestyle and environment, genetic and extends from risk equations to genetic testing.

Technological development in precision medicine is anticipated to continue, organized by programmes like Precision Medicine Initiative and around 1,00,000 Genomes Project. The invention will change the way healthcare services deliver and organize. Precision medicine will be helpful for creating new molecular testing infrastructure and advanced health information systems studying the health and molecular data to notify future prevention, treatment and detection strategies. This shows the significance of production of economic and clinical evidence, signifying the healthcare decision makers, involving health technology assessment agencies and the producers of the guideline, considering the processes and methods accommodating new services and technology.

HTA agencies understand precision medicine with companion diagnostics and diagnostic tests referring to recognizing biomarkers related to treatment response like HER2 receptor protein for the pharmacotherapies of breast cancer. Various countries have lodged the supplementary complexities of assessing the tests with new procedures like Health, Technology Assessment Access Point in Australia or Diagnostic Assessment Program at National Institute for Health and Care Excellence (NICE) in England. On the other hand, extra procedures are required for developing technologies of precision medicine.

Precision Medicine Definition

The initial consideration for the study was to describe the types of services and technologies that incorporate precision medicine. Precision medicine embraces the pharmacogenomics and pharmacogenetic tests and the word now used is with stratified medicine. It is changing the term personalized medicine and covers the technologies offering exceptional pathways of treatment for individual patients.

Advancements in Technology

There are three types of precision medicine technology probable to develop in the coming years : ‘omics’ based tests, digital health applications and complex algorithms.

‘Omics’ based tests

Various precision medicine tools are using genomic and genetic information to anticipate disease prognosis and expect treatment response. The senior health economist estimated the use of ‘omics’ based biomarkers like lipidomics, metabolomics and proteomics are becoming the partial and common genomics over the forecast period.

‘Omics’ based testing is anticipated to improve in scope and complexity, with distinct tests notifying pathway of treatment, disease risk for various diseases or the choices for therapy. Whole-genome sequencing is the biggest end of this scale and can deliver information on treatment decisions for several diseases.

Digital Health Applications

Health applications involve a huge range of tools providing advice on disease management, process and receiving and registering data of patients like physiological and physical activity like heart rate. A separation of applications is likely to fall in precision medicine, in using the AI-based technology. Several health applications are anticipated to surge substantially in the coming years. Digital health experts projected the main developments in the region, including the applications analyzing the lifestyle determinants of health like physical activity or the socio-economic activity to stratify patients by the applications linked to monitoring devices. In the year 2017, NICE distributed briefings on mobile technology health applications developed by the programme of NICE medical technologies evaluation, labeled as ‘Health App Briefings’.

Complex Algorithms

The experts projected the enhanced use of algorithms using artificial intelligence to support clinical decision predicted over the forecast period. The algorithms need large datasets including various variables like electronic health records, sociodemographic characteristics and genetic information. On utilizing the information, algorithms deliver the patients and clinicians with predictions on optimal treatment choices and prognosis by using the patient-level characteristics. This technologies based on artificial intelligence is combining with the developments in imaging to improve algorithms incorporating the scan results based on knowledge to provide precise information.

Problems for the assessment of health technology

Interventions of precision medicine will face the tasks at every stage of the HTA procedure from scoping to review.

Scoping

A landscape of the decision problem accessible to HTA agencies and developers of the guideline is difficult to explain the dealing with precision medicine services and technologies. The appearance of the multi-parametric tests is anticipated to enhance the comparators, populations and relevant interventions incorporated by the distinct assignment by delivering the information on various diseases.

The rapid innovation in precision medicine explains that the assessment bodies are facing the developed volumes of assessments. Analyst of NICE described that the scoping workshops, where clinicians and other consultants decide that which technology should be analyzed, is adequate for the appraisal of technology.

Modeling

Decision-Analytic Modelling

Various studies anticipated that the complication of the clinical pathways in precision medicine can boil down the structures of model inadequate for apprehending the advantages and long-term costs. For instance, multi-parametric testing is leading towards the secondary findings discrete to the unique test and spill-over effects on the members of the family and the future generations. Several studies determined that research is required to initiate the best practice guidelines for demonstrating precision medicine whereas others recommended the approaches that can hold the complex structures more sufficiently, like discrete event simulations and microsimulation.

Decision-Making

Hesitation

The stratification of the patient population results in small sample sizes being employed to trials for the interventions of precision medicine. Joined with the variable and complex treatment pathways increasing the levels of hesitation related to the affordability predicts the decision makers.

Another source of hesitation is the unit costs, for instance, ‘omics’ based tests differ by a laboratory. These tests are yielding continuous results, where the thresholds are set to decide the outcome of testing. Thresholds are affecting the affordability of tests and were debated that the determination of beginnings going behind the investigation of receiver functioning the characteristic curves.

Conclusion

Interventions of precision medicine are probable to multiply in the coming years and transform the way health services are evaluated and delivered. These changes might be fueled by the hesitation and complexity about delivering the therapies using the data of biomarker and in addition, the inventive and evolutionary nature of the technologies based on artificial intelligence. Healthcare systems across the globe need to think by regulating the evaluative and procedures method to accommodate the changes continuing to strongly assess the charge for money of new services and treatments.