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法国基因和基因组检测的价值评估:当前挑战与最新证据

Valuing genetic and genomic testing in France: current challenges and latest evidence.

作者信息

Lejeune Catherine, Amado Ines F

机构信息

Inserm CIC 1432, Clinical Epidemiology Unit, Dijon University Hospital, 7 bd Jeanne d'Arc, 21079, Dijon, France.

Inserm, Health Technologies Institute, Paris, France.

出版信息

J Community Genet. 2022 Oct;13(5):477-485. doi: 10.1007/s12687-020-00503-2. Epub 2021 Jan 16.

Abstract

High-throughput next-generation sequencing technologies have seen an increase in use in most developed countries. The translation of genomic testing into clinical practice challenges the traditional model of medical care in France and raises numerous medical, legal, ethical, organizational, and financial issues. In order to allow the population to use this revolution to its advantage, France has conceived the French Plan for Genomic Medicine 2025. Its aim is to improve health and quality of life, to organize new pathways of care and counseling, and to make decisions about insurance coverage. It has also been designed to drive innovation and promote economic growth in France by incorporating genomic medicine into the French health care system. These issues can be addressed through evaluations developed to aid the decision-making process in the context of resource scarcity. Health economists can help to resolve these resource allocation challenges by measuring the impact of this technological revolution on patients, caregivers, providers, and the health care system. In this paper, we will review challenges associated with implementing genomic testing in France. One of the pilot studies of the French Plan for Genomic Medicine 2025 will be presented as an illustration of the role of health economists in overcoming some of the challenges of this technological revolution.

摘要

在大多数发达国家,高通量下一代测序技术的使用有所增加。在法国,将基因组检测转化为临床实践对传统医疗模式构成了挑战,并引发了众多医学、法律、伦理、组织和财务问题。为了让民众从这一变革中受益,法国制定了《2025年法国基因组医学计划》。其目标是改善健康和生活质量,规划新的护理和咨询途径,并就保险覆盖范围做出决策。该计划还旨在通过将基因组医学纳入法国医疗体系来推动创新并促进法国的经济增长。在资源稀缺的背景下,可以通过开展评估来辅助决策过程,从而解决这些问题。健康经济学家可以通过衡量这一技术变革对患者、护理人员、医疗服务提供者和医疗体系的影响,帮助解决这些资源分配挑战。在本文中,我们将审视在法国实施基因组检测所面临的挑战。作为健康经济学家在克服这一技术变革的某些挑战中所发挥作用的例证,我们将介绍《2025年法国基因组医学计划》的一项试点研究。

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