Payer perspectives on genomic testing in the United States: A systematic literature review.

Autor:	Wiedower J; Clemson University, School of Nursing, Clemson, SC; Guardant Health, Redwood City, CA. Electronic address: jkaylor@guardanthealth.com., Smith HS; Precision Medicine Translational Research (PROMoTeR) Center, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA; Center for Bioethics, Harvard Medical School, Boston, MA., Farrell CL; Clemson University, School of Nursing, Clemson, SC., Parker V; Clemson University, School of Nursing, Clemson, SC., Rebek L; Guardant Health, Redwood City, CA., Davis SC; Clemson University, School of Nursing, Clemson, SC.
Jazyk:	angličtina
Zdroj:	Genetics in medicine : official journal of the American College of Medical Genetics [Genet Med] 2024 Nov 15; Vol. 27 (2), pp. 101329. Date of Electronic Publication: 2024 Nov 15.
DOI:	10.1016/j.gim.2024.101329
Abstrakt:	Purpose: Health care stakeholders' perspectives on the value of genomic testing vary widely and directly affect the access and practice of genomic medicine. To our knowledge, a review of US health care payers' perspectives on genomic testing has not been performed. Methods: We conducted a systematic literature review of US payers' perspectives on genomic testing in the MEDLINE, PubMed, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Of the 161 nonduplicate records screened, we summarized findings from 20 included records, and using the framework method, common domains were recorded. Results: Domains included clinical utility, coverage decision frameworks, potential harms, costs, paying for research, demand/pressure, the flexibility of outcomes considered, and personal utility. There was consensus on the definition of clinical utility as improved health outcomes, and the nuances of genomic testing were reported as challenging to fit within existing coverage decision frameworks. Perspectives varied on accepting broader outcomes or uses of genomic testing and whether costs influence coverage decisions. Study methodologies were heterogeneous. Conclusion: A deeper understanding of how payers approach genomic testing may allow comparison with other stakeholders' perspectives and may identify challenges, opportunities, and solutions to align a conceptual and evidentiary framework better to demonstrate the value of genomic testing. Competing Interests: Conflict of Interest Julie Wiedower and Laura Rebek are employees of and hold stock in Guardant Health, a molecular diagnostics laboratory. Hadley Stevens Smith has received consulting income from Illumina, Inc that is unrelated to this work. (Copyright © 2024 American College of Medical Genetics and Genomics. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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