International Journal of Health Policy and Management

International Journal of Health Policy and Management

An Economic Reference Case for Precision Medicine – Are We There Yet?; Comment on “Development of the PICCOTEAM Reference Case for Economic Evaluationof Precision Medicine”

Articles in Press

Document Type : Commentary

Authors
Dean A. Regier 1, 2, 3
Emanuel Krebs 2, 3
Deirdre Weymann 2, 3, 4
1 School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
2 Regulatory Science Lab, BC Cancer Research Institute, Vancouver, BC, Canada
3 Academy of Translational Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
4 Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
Abstract
Precision medicine interventions challenge the conduct of health economic evaluations. Precision medicine often targets small benefitting populations, which results in complex direct and indirect consequences for patients, health systems, and society. These complexities are not directly addressed by existing reference cases guiding the economic evaluation of health technologies. Chen and colleagues sought to address this gap. Through a multi-stage process involving expert consultation, literature review, and consensus seeking, they developed the PICCOTEAM (Population, Intervention, Comparator, Cost, Outcome, Time, Equity and ethics, Adaptability, and Modelling) reference case specifying 46 recommendations for conventional economic evaluations of precision medicine, and 30 additional recommendations for early-stage evaluations. This commentary discusses the contribution of the PICCOTEAM recommendations and identifies opportunities to strengthen future development of an economic reference case for precision medicine. Our recommendations include clarifying institutional purpose and values, broadening technological scope, and considering how the reference case could be applied across the technology life cycle to support iterative, evidence-informed healthcare decision-making.
Keywords
Precision Medicine
Genetic Test
Reference Case
Economic Evaluation
Cost Effectiveness
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International Journal of Health Policy and Management

Articles in Press, Corrected Proof
Available Online from 04 November 2026

  • Received Date 30 July 2026
  • Revised Date 07 October 2026
  • Accepted Date 20 October 2026
  • First Published Date 04 November 2026
  • Published Date 04 November 2026