Healthcare magazine for research scientists, labs, pathologists, hospitals, cancer centers, physicians and biopharma companies providing news articles, expert interviews and videos about molecular diagnostics in precision medicine
Issue link: https://clinicalomics.epubxp.com/i/853204
10 Clinical OMICs July/August 2017 www.clinicalomics.com Publisher & CEO MARY ANN LIEBERT President MARIANNE RUSSELL Group Publisher SANDE GIACCONE Editor in Chief CHRIS ANDERSON EVP, Strategic Development KEVIN DAVIES Commercial Director BILL LEVINE Production Editor ROBERT M. REIS Senior Editor KEVIN MAYER Technical Editor JEFFREY S. BUGULISKIS, Ph.D. Senior News Editor ALEX PHILIPPIDIS Chief Copy Editor STEVEN HERNACKI Contributing Editors HELEN ALBERT, MALORYE BRANCA, MEGHAAN FERREIRA, DIANA KWON Art Director JAMES LAMBO Online Product Manager THOMAS MATHEW Associate Director of Brand Marketing JENNIFER GATTI Online Editorial Supervisor KATHERINE VUKSANAJ Design & Layout NORA WERTZ Advertising Sales Manager DENIS SEGER US West & Asia Pacific (dseger@clinicalomics.com / 760-518-5222) Advertising Sales Manager LARRY MAHER US East, UK, & Europe (lmaher@clinicalomics.com / 312-342-0849) Sales Administrator FALLON MURPHY Advertising Material WANDA SANCHEZ (wsanchez@liebertpub.com) Clinical OMICs Advisory Board DANIEL H. FARKAS, Ph.D., HCLD Chief Clinical Laboratory Officer, Celmatix JEFFREY GIBBS, J.D. Director, Hyman, Phelps, and McNamara PETER HARRSCH, Ph.D. Executive Clinical/Forensic Specialist, Waters Corp. ROGER KLEIN, M.D., J.D. Medical Director, Molecular Pathology, Cleveland Clinic JASON PARK, M.D., Ph.D. Assistant Professor, Dept. of Pathology, University of Texas Southwestern Medical Center STEPHEN C. PEIPER, M.D. Professor & Chair, Dept. of Pathology, Anatomy & Cell Biology, Thomas Jefferson University AMIT RASTOGI Senior Vice President, Strategy, Growth, and Innovation, Inova DAVID SMITH, Ph.D. Professor of Laboratory Medicine and Pathology, Mayo Clinic KIMBERLY STRONG, Ph.D. Director, Program in Genomics and Ethics, Medical College of Wisconsin LARRY WORDEN Vice President and Senior Partner, Market Diagnostics International The views, opinions, findings, conclusions, and recommendations set forth in any article in Clinical OMICs are solely those of the authors of those articles and do not necessarily reflect the views, policy, or position of Clinical OMICs, its Publisher, or its editorial staff and should not be attributed to any of them. All advertisements are subject to review by the Publisher. The acceptance of advertisements does not constitute an endorsement of the product or service advertised. Clinical OMICs (ISSN-2334-1351) is published online bimonthly by GEN Publishing, 140 Huguenot St., 3rd Floor, New Rochelle, NY 10801-5215. For subscription information go to: www.clinicalomics.com Copyright © 2017 by GEN Publishing, New Rochelle, NY I t's no secret that diagnostic companies often feel they get the short end of the stick when it comes getting reimbursement from the likes of Medi- care, Medicaid, and the private insurance companies. For medical centers using next-generation sequencing, or other sequencing techniques to pro- vide a more precise diagnosis for their patients, the road has been equally—if not doubly—hard. There are two elements at play: the costs of the tests themselves; and hard evidence that the tests effectively diagnose a specific con- dition while also providing for better outcomes. Granted, some tests that rely on genetic information, like noninvasive pre- natal testing (NIPT), are getting reimbursed. For NIPT, its less invasive—and, hence, less risky—testing method has spurred uptake by OB-GYNs, and the prospect of reducing medical costs when the other methods go wrong have caused most payers to jump on board. But what of NGS-based diagnostics? While it is certainly an area that is awash in data, not enough of them are the kind of data that insurers seek when making decision on what procedures and tests they are willing to pay for. When it comes to developing that evidence, Joydeep Goswami, president of clinical NGS and oncology at Thermo Fisher Scientific thinks the insurance companies themselves can play a role in bringing NGS-based diagnostics into broader clinical practice. "I feel the payers, especially the larger payers, can push the field forward much faster than individual hospitals or medical centers can. Because they can run multicenter trials with patients that are in their system to collect the kind of data that would provide the utility of the technology much faster, if they were so inclined. That is an area where we are trying to convince payers that they should take the lead," he said. Granted, this would be a step outside the normal comfort zone for insurers. But in today's healthcare environment, it is an investment that could be in their best interests. With more and more targeted therapies, and combination therapies for cancer coming to light, getting these patients on the right treat- ment is an area ripe for savings. After all, name me an insurance company that is in favor of paying for a wrong—and likely very expensive—cancer treatment. Making this commitment should be somewhat easier for insurers, too, as in the past decade the move away from a fee-for-service model to value-based care payment structures has seen them sitting at the same table with health- care providers as partners instead of adversaries. So, if healthcare is truly going to transition to providing precision care to its patients leveraging NGS, then it is time for insurers to make a concerted effort to support these efforts. Doctors on the front lines know the benefit of these methods intuitively. Insurers should partner with them to prove it. —Chris Anderson, Editor in Chief FROM THE EDITOR Chris Anderson Editor in Chief Insurers Have a Crucial Role in NGS Diagnostics Adoption