Assessing value of innovative molecular diagnostic tests in the concept of predictive, preventive, and personalized medicine

Abstract

Molecular diagnostic tests drive the scientific and technological uplift in the field of predictive, preventive, and personalized medicine offering invaluable clinical and socioeconomic benefits to the key stakeholders. Although the results of diagnostic tests are immensely influential, molecular diagnostic tests (MDx) are still grudgingly reimbursed by payers and amount for less than 5 % of the overall healthcare costs. This paper aims at defining the value of molecular diagnostic test and outlining the most important components of "value" from miscellaneous assessment frameworks, which go beyond accuracy and feasibility and impact the clinical adoption, informing healthcare resource allocation decisions. The authors suggest that the industry should facilitate discussions with various stakeholders throughout the entire assessment process in order to arrive at a consensus about the depth of evidence required for positive marketing authorization or reimbursement decisions. In light of the evolving "value-based healthcare" delivery practices, it is also recommended to account for social and ethical parameters of value, since these are anticipated to become as critical for reimbursement decisions and test acceptance as economic and clinical criteria.

Keywords: Companion diagnostics; Cost-effectiveness; Economic models; Health technology assessment; Market access; Predictive Preventive Personalized Medicine; Reimbursement; Strategy; Value.

Fig. 1

Graphic representation of the ACCE system for assessing genomic tests (adapted from Haddow and Palomaki [46])