Monday July 22, 2024

Payers : Gatekeepers or translational bridge to personalized medicine

March 11th, 2012 - (William J Canestaro; Lori A Martell; E Robert Wassman; Rick Schatzberg) -Personalized Medicine


Healthcare payers represent stakeholders who can act as either a bridge or a gate to the translation of personalized medicine into routine clinical practice. To date, the slow realization of the promise of personalized medicine has been partly attributable to the lack of clear evidence supporting the clinical utility of genetic and genomic tests and the lag in development of clinical guidelines for the use and interpretation of tests.


Success for personalized medicine depends on how quickly health insurance plans will develop appropriate coverage guidelines along with a fair reimbursement policy. As physicians strive to deliver treatments and tests that inform clinical decisions and improved outcomes for their patients, payers must learn about new laboratory tests and create policies to reimburse for tests with clinical value.


The design of alternative strategies for collaborative evidence-generation, clinical decision support and educational initiatives for healthcare providers, patients and the payers themselves are critical needs to achieve the full benefit of personalized medicine in day-to-day healthcare settings.

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