UMMS Affiliation

Meyers Primary Care Institute

Publication Date

2018-10-01

Document Type

Article

Disciplines

Diagnosis | Genetics and Genomics | Health Policy | Health Services Administration | Insurance | Neoplasms | Pharmaceutical Preparations | Pharmacoeconomics and Pharmaceutical Economics | Pharmacy Administration, Policy and Regulation | Therapeutics

Abstract

Recent advances in genomic medicine have led to the availability of genomic tests that have the potential to improve population health, yet the process for obtaining these tests and getting them reimbursed by insurers has not been described. The objective of this study was to describe the process of ordering pharmacogenomic tests by interviewing providers, patients, and laboratories about cancer-related pharmacogenomic tests. We interviewed patients who were prescribed, providers who prescribed medications that should be guided by pharmacogenomic testing, and individuals from diagnostic laboratories. A total of 10 providers, 16 patients, and eight diagnostic laboratories described logistical and insurance issues relating to ordering and receiving pharmacogenomic tests and medications. We found that the process of ordering pharmacogenomic tests is time-consuming, expensive, and complex. Ordering pharmacogenomic tests is quite different across institutions. Even in the same institution, multiple providers can order the test. Once the provider places the order for the pharmacogenomic test, the laboratory receives the request and usually begins testing without knowing how the test will be paid for. Next, the laboratory completes the pharmacogenomic testing and the results of the tests are reported to providers, patients, or placed directly in the medical record. In conclusion, processes related to ordering and obtaining insurance coverage for pharmacogenomic tests varies greatly across institutions and is time-consuming.

Keywords

cancer, implementation, pharmacogenomics, precision medicine, personalized medicine

Rights and Permissions

© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

DOI of Published Version

10.3390/jpm8040032

Source

J Pers Med. 2018 Oct 1;8(4). pii: jpm8040032. doi: 10.3390/jpm8040032. Link to article on publisher's site

Journal/Book/Conference Title

Journal of personalized medicine

Related Resources

Link to Article in PubMed

PubMed ID

30275409

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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