4.2 Article

Insurance coverage for pharmacogenomic testing in the USA

期刊

PERSONALIZED MEDICINE
卷 4, 期 4, 页码 479-487

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FUTURE MEDICINE LTD
DOI: 10.2217/17410541.4.4.479

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clinical utility; clinical validity; coverage decision; experimental; investigational; medical necessity; oversight; pharmacogenetics; pharmacogenomics

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The completion of the Human Genome Project has led to claims that we are on the verge of entering the era of 'personalized medicine'. Some initial, highly visible successes have positioned pharmacogenomics as the poster child for this new era. Many commercial referral laboratories are offering pharmacogenomic assays. In the US healthcare system, payers have had a significant impact on utilization of new drugs and technologies. Payers are frequently characterized as a barrier to the rapid dissemination of innovative therapies. In reality, payers are frequently the only group that scrutinize these new therapies for utility. As such, they play a critical role in assuring that their members are receiving appropriate care.

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