| Health technology assessment and private payers' coverage of personalized medicine. | |
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MedLine Citation:
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PMID: 21886515 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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PURPOSE: Health technology assessment (HTA) plays an increasing role in translating emerging technologies into clinical practice and policy. Private payers are important users of HTA whose decisions impact adoption and use of new technologies. We examine the current use of HTA by private payers in coverage decisions for personalized medicine, a field that is increasingly impacting oncology practice. STUDY DESIGN: Literature review and semistructured interviews. METHODS: We reviewed seven HTA organizations used by private payers in decision making and explored how HTA is used by major US private payers (n = 11) for coverage of personalized medicine. RESULTS: All payers used HTA in coverage decisions, but the number of HTA organizations used by an individual payer ranged from one (n = 1) to all seven (n = 1), with the majority of payers (n = 8) using three or more. Payers relied more extensively on HTAs for reviews of personalized medicine (64%) than for other technologies. Most payers (82%) equally valued expertise of reviewers and rigor of evaluation as HTA strengths, whereas genomic-specific methodology was less important. Key reported shortcomings were limited availability of reviews (73%) and limited inclusion of nonclinical factors (91%), such as cost-effectiveness or adoption of technology in clinical practice. CONCLUSION: Payers use a range of HTAs in their coverage decisions related to personalized medicine, but the current state of HTA to comprehensively guide those decisions is limited. HTA organizations should address current gaps to improve their relevance to payers and clinicians. Current HTA shortcomings may also inform the national HTA agenda. |
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Authors:
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Julia R Trosman; Stephanie L Van Bebber; Kathryn A Phillips |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of oncology practice / American Society of Clinical Oncology Volume: 7 ISSN: 1935-469X ISO Abbreviation: J Oncol Pract Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-09-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101261852 Medline TA: J Oncol Pract Country: United States |
Other Details:
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Languages: eng Pagination: 18s-24s Citation Subset: - |
Affiliation:
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Center for Translational and Policy Research in Personalized Medicine and Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco; Center for Business Models in Healthcare, San Francisco, CA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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