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在预测性、预防性和个性化医疗的概念下评估创新分子诊断测试的价值。

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

作者信息

Akhmetov Ildar, Bubnov Rostyslav V

机构信息

Strategic Market Intelligence Dep., Unicorn, P.O.B. 91, Zhytomyr, 10020 Ukraine.

Clinical Hospital "Pheophania" of State Affairs Department, Zabolotny Str., 21, Kyiv, 03680 Ukraine ; Zabolotny Institute of Microbiology and Virology, National Academy of Sciences of Ukraine, Zabolotny Str., 154, Kyiv, 03680 Ukraine.

出版信息

EPMA J. 2015 Sep 30;6:19. doi: 10.1186/s13167-015-0041-3. eCollection 2015.

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.

摘要

分子诊断测试推动了预测性、预防性和个性化医学领域的科技进步,为关键利益相关者带来了宝贵的临床和社会经济效益。尽管诊断测试的结果具有巨大影响力,但分子诊断测试(MDx)仍未得到支付方的充分报销,在总体医疗费用中所占比例不到5%。本文旨在界定分子诊断测试的价值,并从各种评估框架中概述“价值”的最重要组成部分,这些框架超越了准确性和可行性,影响临床应用,为医疗资源分配决策提供信息。作者建议,该行业应在整个评估过程中促进与各利益相关者的讨论,以便就积极的营销授权或报销决策所需的证据深度达成共识。鉴于“基于价值的医疗保健”提供方式的不断演变,还建议考虑价值的社会和伦理参数,因为预计这些参数对报销决策和测试接受度将与经济和临床标准一样重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/624b/4588236/e65f9383b2e3/13167_2015_41_Fig1_HTML.jpg

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