PhD defence C. (Christina) Mitropoulou

The central aim of Personalized Medicine is to exploit the individual’s genomic information to support the clinical decision-making process. Pharmacogenetics is the relation between hereditary factors and drug metabolizing capacity. Later, the term “Pharmacogenomics” was introduced, covering pharmacogenetics, but also including other genomic variants identified in the genome affecting drug metabolism. Progress made in the development of personalized medicine in recent decades has coincided with health care systems placing greater emphasis on evidence-based clinical practice, particularly as they are operating within an increasingly budget-scarce environment. It is often argued that personalizing treatment will inevitably improve clinical outcomes for patients and help achieve more effective use of health care resources. Hence, demand is increasing for demonstrable evidence of clinical utility and cost-effectiveness to support the use of personalized medicine in health care. Pharmacogenomics is a core component of Personalized Medicine and as such, it will be used as an example to highlight the application of economic evaluation in Personalized Medicine. The aim of the present thesis was to assess the health benefits of genome-guided treatment interventions, in comparison with the standard interventions used in the current medical practice. We focus on the economic analysis of pharmacogenomic-guided warfarin and clopidogrel treatment, particularly since in recent years cardiology became the key medical specialty in which pharmacogenetics applications are emerging into practice. Furthermore, in this thesis, we investigated, through structural questionnaires, the views, opinions and attitudes of the various stakeholders and of the general public about genomic medicine and its impact to society. Lastly, we proposed an alternative methodological approach for cost-effectiveness analysis and developed a practical guidance for decision making by budget holders.

Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall of the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.