Previous reviews on the cost-effectiveness of personalized medicine (PM) have found that most PM interventions increase costs and health benefits. They have also found large heterogeneity in outcomes. We expand on previous research by focusing on incremental net monetary benefit (ΔNMB) as opposed to incremental cost-effectiveness ratios, which allows for easy ranking of the interventions and for assessing the magnitude of their benefit. We explore the heterogeneity in outcomes using regression analysis.
PM interventions were found to have modest health benefits compared with non-PM. Nevertheless, its costs tend to result in 0 to negative ΔNMB on average. Gene therapies were found to have larger health benefits than other PM interventions. Nevertheless, they were also associated with higher costs and significantly lower ΔNMB, though this finding was sensitive to (small) data changes and hence uncertain. PM interventions for neoplasms had lower Δcosts and larger ΔNMB than PM interventions for other conditions, yet average ΔNMB in the 'neoplasm' group was still negative. Pricing policies may be needed to reduce the costs of gene therapies and other interventions with negative ΔNMB.
Beyond the difference between gene therapies and other PM interventions, no statistically significant factors could be identified to explain the large heterogeneity in cost-effectiveness outcomes. It appears that the term “personalized medicine” may be too general given that it conceals sizable differences in the net benefit of different PM interventions. A more precise division into subcategories of PM may be needed to uncover the most promising areas for further investment.