DANA POINT, Calif. — Even the best treatment for a disease is no help if you can’t pinpoint the patients who need it. And a panel of experts this week grappled with the fact that securing payment for new diagnostics remains a major hurdle to turning personalized medicine’s splashy promises into reality.
The discussion, held Thursday at the 16th annual Personalized Medicine Conference, comes at a time when more companies are launching tests that mine treasure troves of biological data for signs of disease in a bid to match the right treatment to the right patient. But the panel underscored a hard truth: Developing a diagnostic test is one thing, ensuring it’s widely available is another.
Representatives of insurance companies, venture firms, and health service groups pointed out that it’s often unclear what standards test developers must meet to secure reimbursement, with the bar sometimes varying from payer to payer. They also pointed to potential solutions, urging companies to speak with payers sooner and pointing to partnerships between test makers and payers designed to generate evidence that could support favorable coverage decisions.
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