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首页> 外文期刊>Journal of Personalized Medicine >Insurance Coverage Policies for Pharmacogenomic and Multi-Gene Testing for Cancer
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Insurance Coverage Policies for Pharmacogenomic and Multi-Gene Testing for Cancer

机译：癌症药物基因组和多基因检测的保险范围政策

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Insurance coverage policies are a major determinant of patient access to genomic tests. The objective of this study was to examine differences in coverage policies for guideline-recommended pharmacogenomic tests that inform cancer treatment. We analyzed coverage policies from eight Medicare contractors and 10 private payers for 23 biomarkers (e.g., HER2 and EGFR ) and multi-gene tests. We extracted policy coverage and criteria, prior authorization requirements, and an evidence basis for coverage. We reviewed professional society guidelines and their recommendations for use of pharmacogenomic tests. Coverage for KRAS , EGFR , and BRAF tests were common across Medicare contractors and private payers, but few policies covered PML / RARA , CD25 , or G6PD . Twelve payers cover at least one multi-gene test for nonsmall cell lung cancer, citing emerging clinical recommendations. Coverage policies for single and multi-gene tests for cancer treatments are relatively consistent among Medicare contractors despite the lack of national coverage determinations. In contrast, coverage for these tests varied across private payers. Patient access to tests is governed by prior authorization among eight private payers. Substantial variations in how payers address guideline-recommended pharmacogenomic tests and the common use of prior authorization underscore the need for additional studies of the effects of coverage variation on cancer care and patient outcomes.
机译：保险范围政策是患者获得基因组测试的主要决定因素。这项研究的目的是检查指导癌症推荐的药物基因组学测试的覆盖策略的差异。我们分析了8个Medicare承包商和10个私人付款人的承保政策，涉及23种生物标志物（例如HER2和EGFR）和多基因检测。我们提取了政策覆盖率和标准，事先授权要求以及覆盖率的证据基础。我们审查了专业协会指南及其关于药物基因组学测试的建议。在Medicare承包商和私人付款人中，KRAS，EGFR和BRAF测试的范围很普遍，但是很少有政策涵盖PML / RARA，CD25或G6PD。十二项付款者引用了新兴的临床建议，涵盖了至少一项针对非小细胞肺癌的多基因测试。尽管缺乏全国保险范围的确定，但医疗保险承包人中针对癌症治疗的单基因和多基因测试的保险范围政策相对一致。相反，这些测试的覆盖范围因私人付款人而异。患者获得测试的权限由八名私人付款人事先授权进行管理。付款人应对指南推荐的药物基因组学测试的方式存在显着差异，并且事先授权的普遍使用突显了需要进一步研究承保范围差异对癌症护理和患者预后的影响。

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