Payment for Cancer Biomarker Testing

Allen, Timothy Craig

doi:10.5858/arpa.2014-0190-ed

Cited by 5 publications

(8 citation statements)

References 16 publications

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“…As for ambulatory medicine, the use of retrospective reimbursement on the one hand, and fee-forservice scheme on the other, favor the therapeutic cascade that may contribute to increase health expenditure. However, as mentioned by Allen (2015), other payment schemes that aim to align incentives between payers and providers can also be implemented to contain healthcare costs. We will develop these payment schemes in the next section.…”

Section: Physicians' Incentives To Use Diagnostic Testsmentioning

confidence: 99%

“…In a short qualitative article, Allen (2015) explains that the majority of American payers reimburse separately biomarker tests and the associated treatments. According to this author, this institutional arrangement does not seem to be optimal in the sense that few biomarker tests are prescribed.…”

Section: Reimbursement Rule and Payment Schemes: Diagnostic Test And ...mentioning

confidence: 99%

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Economic Incentives to Develop and to Use Diagnostic Tests a Literature Review

Bardey,

De Donder,

Zaporozhets

2024

SSRN Journal

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Section: Physicians' Incentives To Use Diagnostic Testsmentioning

confidence: 99%

Section: Reimbursement Rule and Payment Schemes: Diagnostic Test And ...mentioning

confidence: 99%

Economic Incentives to Develop and to Use Diagnostic Tests a Literature Review

Bardey,

De Donder,

Zaporozhets

2024

SSRN Journal

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“…It remains to be seen how private payers and the CMS will respond to PD-L1 testing; however, pathologist medical society guidance, such as that already being provided by the College of American Pathologists for molecular biomarker testing payment, will be instrumental to ensure appropriate patient selection for testing, and adequate payment for the performance of PD-L1 tests and interpretation of their results. 13 …”

Section: What Regulatory Issues Will Arise?mentioning

confidence: 99%

PD-L1 and Lung Cancer: The Era of Precision-ish Medicine?

Allen

2016

Archives of Pathology &Amp; Laboratory Medicine

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The success of immune checkpoint inhibitor therapy in lung cancer, both in squamous and nonsquamous non–small cell carcinoma, has led to US Food and Drug Administration approval for 2 medications that have as part of their prescribing information an associated immunohistochemistry-based companion or complementary diagnostic test for programmed death ligand-1 (PD-L1). The intense interest in drug development in this area has resulted in additional agents with associated diagnostics looming on the horizon in 2016. In the era of precision medicine, the paradigm of paired molecular target and molecular test, which serves as a model of oncogenic mutation-driven cancer therapy, is challenged by the proliferation of immunohistochemistry-based tests with different antibodies, instruments, and scoring. The difficulty inherent to targeted therapy aimed at a moving target is discussed, as well as the emerging challenges to pathologists and oncologists who seek to optimize care in this complex therapeutic arena.

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“…What is still research today may rapidly become routine clinical management tomorrow. Already the considerable investment into the future of PM is starting to pay off for itself in many ways with some dramatic changes in therapeutic approaches and outcomes [ 10 , 11 , 12 ]. The regulatory approval process for new treatments resulting from developments in PM research should be revisited to contain costs and time loss as a major hindrance to medical progress [ 13 ].…”

Section: Precision Medicine and Personalized Approach To Illnessmentioning

confidence: 99%

Precision Medicine and Non-Colorectal Cancer Liver Metastases: Fiction or Reality?

Liakopoulou

2015

Visc Med

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Background: Non-colorectal liver metastases (nCRLM) constitute a variety of heterogeneous diseases and a considerable therapeutic challenge. Management is based on the primary tumor and the clinical course. In the era of precision medicine (PM) we know that cancer is heterogeneous within the tumor and across different sites. Methods: We give an overview of the path to PM through ‘omics' beyond genomics. We refer to the experience gained to date from models such as colorectal cancer and we discuss the opportunity offered by PM for the management of nCRLM. Results: In order to best characterize and track tumor biological behaviors as well as to understand mechanisms of response to therapy and survival we suggest the application of novel clinical trial designs, a dynamic approach with serial monitoring involving evaluation of primary and metastatic sites. Quality and standardization of tissue acquisition and biobanking is a precondition for the reliability of this approach. Conclusion: The application of PM is increasingly becoming a reality. Elucidating the mysteries of tumors in complex settings can only be achieved with the approach PM offers. nCRLM may serve as a model for the application of PM principles and techniques in understanding individual diseases and also cancer as an entity and therapeutic challenge.

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Payment for Cancer Biomarker Testing

Cited by 5 publications

References 16 publications

Economic Incentives to Develop and to Use Diagnostic Tests a Literature Review

Economic Incentives to Develop and to Use Diagnostic Tests a Literature Review

PD-L1 and Lung Cancer: The Era of Precision-ish Medicine?

Precision Medicine and Non-Colorectal Cancer Liver Metastases: Fiction or Reality?

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