Meyers Primary Care Institute
Diagnosis | Genetics and Genomics | Health Policy | Health Services Administration | Insurance | Neoplasms | Pharmaceutical Preparations | Pharmacoeconomics and Pharmaceutical Economics | Pharmacy Administration, Policy and Regulation | Therapeutics
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.
cancer, implementation, pharmacogenomics, precision medicine, personalized medicine
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© 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
J Pers Med. 2018 Oct 1;8(4). pii: jpm8040032. doi: 10.3390/jpm8040032. Link to article on publisher's site
Journal of personalized medicine
Wu, Ann Chen; Mazor, Kathleen M.; Ceccarelli, Rachel; Loomer, Stephanie; and Lu, Christine Y., "The Implementation Process for Pharmacogenomic Testing for Cancer-Targeted Therapies" (2018). Open Access Articles. 3640.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Diagnosis Commons, Genetics and Genomics Commons, Health Policy Commons, Health Services Administration Commons, Insurance Commons, Neoplasms Commons, Pharmaceutical Preparations Commons, Pharmacoeconomics and Pharmaceutical Economics Commons, Pharmacy Administration, Policy and Regulation Commons, Therapeutics Commons