Refining a precision medicine economic evaluation framework: Insights from a multi-stakeholder consultative workshop
Year: 2026
Type: article
Abstract: A reference case (RC), hereafter referred to as population, intervention, comparator, costs, outcomes, time, ethics & equity, adaptability, modeling (PICCOTEAM) RC, was developed to guide the conduct and reporting for economic evaluations (EEs) of precision medicine (PM). To strengthen its applicability and implementation, a multistakeholder consultative workshop was convened to i) obtain feedback on the feasibility and clarity of PICCOTEAM RC components, ii) identify practical challenges in implementing PM evaluations, and iii) promote shared learning and regional collaboration. This paper summarizes workshop insights and recommends refinements to the PICCOTEAM RC with particular attention to methodological, ethical, and equity considerations in PM policy and reimbursement. The three-day consultative workshop involved 25 participants, comprising five research teams from Singapore ( n = 11), two from Thailand ( n = 5), and nine independent experts. The workshop included presentations on existing challenges in PM EE, an introduction to PICCOTEAM RC, and a World Café session for feedback and refinement. Workshop insights indicated stakeholders considered generic RCs insufficient for guiding PM EEs. Key challenges included uncertainty in modelling outcomes and costs, patient heterogeneity, undefined risk thresholds, complex test-treatment pathways, lack of clinical guidelines, regulatory policies, and intergenerational effects. Key recommendations included clearer population definitions, periodic updates to definitions as PM tests evolve, incorporation of scenario analyses, adoption of societal perspectives where appropriate, and use of expert elicitation when evidence is limited. To enhance uptake and utilisation of the PICCOTEAM RC, stakeholders suggested using it as a mandatory checklist for publications and improving its digital accessibility. The workshop demonstrated the value of deliberative stakeholder engagement in refining RCs for PM. The feedback has informed updates to the PICCOTEAM RC to support more robust, equitable, and context-specific PM evaluations.
Source: Pharmacoeconomics and Policy
Authors: Dimple Butani, Yah Ru Juang, Laura Huey Mien Lim, Alec Morton, Jingmei Li, Jamaica Briones, Jing Lou, Naline Gandhi, Hwee-Lin Wee, Joanne Yuen Yie Ngeow, Kar Hui Ng, Namfon Sribundit, Nattiya Kapol, Chotika Suwanpanich, Parntip Juntama, Peh Joo Ho, Pritaporn Kingkaew, Sara Tasnim, Sharon Li Ting Pek, Thamonwan Dulsamphan, Tanainan Chuanchaiyakul, Vorasuk Shotelersuk, Wanrudee Isaranuwatchai, Yi Wang, Yue Zhang, Yot Teerawattananon, Wenjia Chen
Institutions: Ministry of Public Health, Health Intervention and Technology Assessment Program, National University of Singapore, Agency for Science, Technology and Research, National University Health System, Genome Institute of Singapore, Duke-NUS Medical School, Nanyang Technological University, National Cancer Centre Singapore, Silpakorn University, Thai Red Cross Society, Chulalongkorn University, King Chulalongkorn Memorial Hospital
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid:
Award: G6192133648
OpenAlex ID: W7207600102