OBJECTIVES: Current economic evaluations (EEs) of precision medicine (PM) often adhere to generic reference cases (RC), overlooking PM’s unique healthcare paradigms. This study aimed to develop a RC to standardize the conduct and reporting of EEs of PM.

METHODS: The working group comprises 5 core health economists, 22 PM experts, and research staff from Singapore, Thailand, and Australia who were actively engaged in EE and clinical PM implementation. The RC development comprised four stages: (1) Conducting expert consultation to shape the RC’s scope and structure across nine domains: Population, Intervention, Comparator, Cost, Outcome, Time, Equity and ethics, Adaptability, Modelling (i.e., “PICCOTEAM” framework); (2) Performing a comprehensive literature review on current PM EE approaches and challenges; (3) Obtaining expert consensus and drafting recommendations; (4) Organizing a workshop for RC refinement based on stakeholder feedback on relevance and feasibility. Following the experts' workshop, consensus was reached to tailor PM recommendations for screening, diagnosis and pharmacogenomics, market-access, and early EEs.

RESULTS: The PICCOTEAM RC offers 40 recommendations for conventional EEs to guide PM reimbursement, emphasizing expert engagement, iterative study processes, disease-specific outcomes, decision uncertainty analyses, and equity considerations. Additionally, 31 recommendations are provided for early-stage evaluation to enhance PM’s positioning and value proposition, and mitigate uncertainty, equity, and ethical issues.

CONCLUSIONS: The PICCOTEAM RC offers a standardized process to conduct and report diverse PM EEs. This will serve as a guidance for health departments, researchers, clinicians, editors, and reviewers. Pilot testing and continuous updates are recommended for ongoing relevance and applicability of this RC.