Test Pricing and Reimbursement in Genomic Medicine: Towards a General Strategy

This paper aims to provide an overview of the rationale and basic principles guiding the governance of genomic testing services, to clarify their objectives, and allocate and define responsibilities among stakeholders in a health-care system, with a special focus on the EU countries. Particular attention is paid to issues pertaining to pricing and reimbursement policies, the availability of essential genomic tests which differs between various countries owing to differences in disease prevalence and public health relevance, the prescribing and use of genomic testing services according to existing or new guidelines, budgetary and fiscal control, the balance between price and access to innovative testing, monitoring and evaluation for cost-effectiveness and safety, and the development of research capacity. We conclude that addressing the specific items put forward in this article will help to create a robust policy in relation to pricing and reimbursement in genomic medicine. This will contribute to an effective and sustainable health-care system and will prove beneficial to the economy at large.

[1]  C. Pui,et al.  Pharmacogenomics and Individualized Medicine: Translating Science Into Practice , 2012, Clinical pharmacology and therapeutics.

[2]  Georges Magonette,et al.  The Joint Research Centre of the European Commission , 2002 .

[3]  D. Cooper,et al.  Critical appraisal of the views of healthcare professionals with respect to pharmacogenomics and personalized medicine in Greece. , 2014, Personalized medicine.

[4]  Sarah Berwouts,et al.  Approaches to quality management and accreditation in a genetic testing laboratory , 2010, European Journal of Human Genetics.

[5]  Sarah Berwouts,et al.  Quality assurance practices in Europe: a survey of molecular genetic testing laboratories , 2012, European Journal of Human Genetics.

[6]  Marc S. Williams,et al.  The Public Health Genomics Translation Gap: What We Don’t Have and Why It Matters , 2012, Public Health Genomics.

[7]  Steve Olson,et al.  Applying an Implementation Science Approach to Genomic Medicine: Workshop Summary , 2016 .

[8]  Personhood and solidarity: what kind of personalized medicine do we want? , 2014, Personalized medicine.

[9]  Michael S Watson,et al.  Genetic testing and FDA regulation: overregulation threatens the emergence of genomic medicine. , 2015, JAMA.

[10]  Kostas Kampourakis,et al.  Key challenges for next‐generation pharmacogenomics , 2014, EMBO reports.

[11]  Athanassios Vozikis,et al.  Stakeholder Analysis in Pharmacogenomics and Genomic Medicine in Greece , 2014, Public Health Genomics.

[12]  Marc S. Williams Can Genomics Deliver on the Promise of Improved Outcomes and Reduced Costs? , 2003 .

[13]  D. Cooper,et al.  A critical view of the general public's awareness and physicians' opinion of the trends and potential pitfalls of genetic testing in Greece. , 2011, Personalized medicine.

[14]  George P Patrinos,et al.  Economic Evaluation of Pharmacogenomics: A Value-Based Approach to Pragmatic Decision Making in the Face of Complexity , 2014, Public Health Genomics.

[15]  G. Patrinos,et al.  Nutrigenomics: A controversy , 2015, Applied & translational genomics.

[16]  Jean-Christophe Nebel,et al.  Meta-Analysis of Genes in Commercially Available Nutrigenomic Tests Denotes Lack of Association with Dietary Intake and Nutrient-Related Pathologies. , 2015, Omics : a journal of integrative biology.

[17]  Thomas A. C. Reydon,et al.  Genetics, genomics and society: the responsibilities of scientists for science communication and education. , 2012, Personalized medicine.

[18]  George P Patrinos,et al.  Pharmacogenomics and public health: implementing 'populationalized' medicine. , 2012, Pharmacogenomics.

[19]  Welfare Administrative Costs OFFICE OF INSPECTOR GENERAL , 1997 .

[20]  Mara G. Aspinall,et al.  The business value and cost-effectiveness of genomic medicine. , 2012, Personalized medicine.

[21]  J. Ashton-Chess,et al.  Market access challenges in the EU for high medical value diagnostic tests. , 2011, Personalized medicine.

[22]  Edd Fleming,et al.  The microeconomics of personalized medicine: today's challenge and tomorrow's promise , 2009, Nature Reviews Drug Discovery.

[23]  Patrick Kierkegaard,et al.  E-Prescription across Europe , 2013 .

[24]  A. Coulter,et al.  European patients' views on the responsiveness of health systems and healthcare providers. , 2005, European journal of public health.

[25]  Darrol J. Baker,et al.  Genetic tests obtainable through pharmacies: the good, the bad, and the ugly , 2013, Human Genomics.

[26]  Insurance coverage for pharmacogenomic testing in the USA. , 2007, Personalized medicine.

[27]  Christopher A. Macisco The Office of Inspector General (OIG) , 2004 .

[28]  Gert Matthijs,et al.  The EuroGentest Clinical Utility Gene Cards continued , 2013, European Journal of Human Genetics.