Perspectives of private payers on multicancer early-detection tests: informing research, implementation, and policy.

Autor:	Trosman JR; UCSF Center for Translational and Policy Research on Precision Medicine (TRANSPERS), San Francisco, CA 94143, United States.; Department of Clinical Pharmacy, University of California San Francisco, San Francisco, CA 94143, United States.; Center for Business Models in Healthcare, Glencoe, IL 60022, United States., Weldon CB; UCSF Center for Translational and Policy Research on Precision Medicine (TRANSPERS), San Francisco, CA 94143, United States.; Center for Business Models in Healthcare, Glencoe, IL 60022, United States., Kurian AW; Stanford University, Stanford, CA 94301, United States., Pasquinelli MM; University of Illinois Chicago, Chicago, IL 60607, United States., Kircher SM; Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States., Martin N; LUNGevity Foundation, Bethesda, MD 20814, United States., Douglas MP; UCSF Center for Translational and Policy Research on Precision Medicine (TRANSPERS), San Francisco, CA 94143, United States.; Department of Clinical Pharmacy, University of California San Francisco, San Francisco, CA 94143, United States., Phillips KA; UCSF Center for Translational and Policy Research on Precision Medicine (TRANSPERS), San Francisco, CA 94143, United States.; Department of Clinical Pharmacy, University of California San Francisco, San Francisco, CA 94143, United States.
Jazyk:	angličtina
Zdroj:	Health affairs scholar [Health Aff Sch] 2023 Jun 20; Vol. 1 (1), pp. qxad005. Date of Electronic Publication: 2023 Jun 20 (Print Publication: 2023).
DOI:	10.1093/haschl/qxad005
Abstrakt:	Emerging blood-based multicancer early-detection (MCED) tests may redefine cancer screening, reduce mortality, and address health disparities if their benefit is demonstrated. U.S. payers' coverage policies will impact MCED test adoption and access; thus, their perspectives must be understood. We examined views, coverage barriers, and evidentiary needs for MCED from 19 private payers collectively covering 150 000 000 enrollees. Most saw an MCED test's potential merit for cancers without current screening (84%), but fewer saw its merit for cancers with existing screening (37%). The largest coverage barriers were inclusion of cancers without demonstrated benefits of early diagnosis (73%), a high false-negative rate (53%), and lack of care protocols for MCED-detected but unconfirmed cancers (53%). The majority (58%) would not require mortality evidence and would accept surrogate endpoints. Most payers (64%) would accept rigorous real-world evidence in the absence of a large randomized controlled trial. The majority (74%) did not expect MCED to reduce disparities due to potential harm from overtreatment resulting from an MCED and barriers to downstream care. Payers' perspectives and evidentiary needs may inform MCED test developers, researchers producing evidence, and health systems framing MCED screening programs. Private payers should be stakeholders of a national MCED policy and equity agenda. Competing Interests: Conflicts of interest Please see ICMJE form(s) for author conflicts of interest. These have been provided as supplementary materials. (© The Author(s) 2023. Published by Oxford University Press on behalf of Project HOPE - The People-To-People Health Foundation, Inc.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu