| Health technology assessment and private payers's coverage of personalized medicine. | |
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MedLine Citation:
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PMID: 21711078 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: 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 7 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 1 (n = 1) to all 7 (n = 1), with the majority of payers (n = 8) using 3 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: The American journal of managed care Volume: 17 ISSN: 1936-2692 ISO Abbreviation: Am J Manag Care Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-06-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9613960 Medline TA: Am J Manag Care Country: United States |
Other Details:
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Languages: eng Pagination: SP53-60 Citation Subset: H |
Affiliation:
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Center for Health Transformation, 1425 K St NW, Ste 450, Washington, DC 20005. E-mail: info@healthtransformation.net. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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