insights - IMS Health

INSIGHTS | PHARMACOGENOMICS
Taking the aforementioned considerations into account, much of the relevant data is actually
already routinely collected in practice. However, the sources are fragmented. Consequently,
often de novo data collection projects are being developed which provide the full and
complete information that is needed. However, these are expensive and time consuming.
An alternative is the linkage of several routine databases (+/- ad hoc data collection). In this
case, linking pathology and/or (pharmaco-) genomics databases, cancer registries and
administrative healthcare or claims databases would provide an ultimately comprehensive RWE
platform allowing for robust pharmacoepidemiology and pharmacovigilance research in
oncology (Figure 2). In Europe, pathology and laboratory databases and cancer registries
provide more details on diagnosis (eg, staging, histological classification, receptor status, etc);
administrative healthcare databases (EMR) and to a certain extent claims data, generally
provide insights into treatment and (co-) morbidities; pathology databases provide more
information on, for example, biomarkers to the extent that they are used in real-world
practice.
In terms of the patient population segmentation driven by PGx, sample size is an important
consideration and often limiting factor in pharmacoepidemiology and pharmacovigilance. To
increase sample size, multiple national databases would need to be harmonized and integrated.
The importance of managing the heterogeneity of underlying healthcare systems, coding and
treatment pathways, and technical aspects (hardware limits) must be taken into account,
particularly in relation to biobanks and PGx databases given their extensive size.
FIGURE 2: LINKING FRAGMENTED DATA SOURCES COVERING CANCER CARE
Pathology
Cancer
register
Genotypic
data
PATIENT CORE
Rx (community
& in-patient)
Microbiology Hospitalizations
Mortality Clinical Lab
PAGE 48 IMS HEALTH ECONOMICS & OUTCOMES RESEARCH
GP