Open AccessClinical Integration of Next Generation Sequencing: Coverage and Reimbursement Challenges
Author(s) -
Deverka Patricia A.,
Dreyfus Jennifer C.
Publication year - 2014
Publication title -
the journal of law, medicine & ethics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.515
H-Index - 57
eISSN - 1748-720X
pISSN - 1073-1105
DOI - 10.1111/jlme.12160
Subject(s) - reimbursement , variety (cybernetics) , enabling , business , personalized medicine , risk analysis (engineering) , health care , computer science , medicine , bioinformatics , economics , biology , economic growth , artificial intelligence , psychiatry
Public and private payers face complex decisions regarding whether, when, and how to cover and reimburse for next generation sequencing (NGS)‐based tests. Yet a predictable reimbursement pathway is critical both for patient access and incentives to provide the market with better clinical evidence. While preliminary data suggests that payers will use similar evidentiary standards as those used to evaluate established molecular diagnostic tests, the volume and complexity of information generated by NGS raises a host of additional considerations for payers that are specific to this technology.