Brixner Diana, Richardson Terry, Lockhart Catherine M, Ramsey Scott, Fox John, Pritchard Daryl, Mcleod Howard, Bobolts Laura, Bourbeau Brian, Crum Erin
Department of Pharmacotherapy, University of Utah, Salt Lake City.
Impact Education, Blue Bell, PA; AMCP and Biologics & Biosimilars Collective Intelligence Consortium, Asheville, NC.
J Manag Care Spec Pharm. 2025 Jun;31(6-a Suppl):S1-S14. doi: 10.18553/jmcp.2025.31.6-a.s1.
Precision medicine in oncology using actionable molecular biomarkers to guide treatment selection has been associated with favorable outcomes; however, many potentially eligible patients do not receive it. This Academy of Managed Care Pharmacy Market Insights program sought to characterize unmet needs in biomarker testing among managed care stakeholders, to develop best practice and consensus recommendations to support addressing these needs, and to gain insights on potential quality measures related to biomarker testing. The program used a modified Delphi process and included in-depth interviews with expert panelists, a national survey of managed care professionals, and a consensus survey of experts. Areas of unmet need in biomarker testing identified were education, guidelines and protocols, timeliness, process, and equity. Twenty-two best practices were suggested by managed care experts and other stakeholders; 9 of these best practices achieved consensus. These consensus recommendations addressed biomarker test ordering and test performance, treatment decisions based on biomarker testing, cost-effectiveness of biomarker testing, and health disparities in access to biomarker testing. Opportunities for education and improvements in infrastructure to implement these recommendations were identified. Further investigation is needed to develop quality measures; although, valuable insights were gained.
肿瘤学中的精准医学利用可操作的分子生物标志物来指导治疗选择，已带来了良好的治疗效果；然而，许多可能符合条件的患者并未接受这种治疗。美国管理式医疗药房学会的这一市场洞察项目旨在明确管理式医疗利益相关者在生物标志物检测方面未满足的需求，制定最佳实践和共识性建议以支持满足这些需求，并深入了解与生物标志物检测相关的潜在质量指标。该项目采用了改良的德尔菲法，包括对专家小组成员进行深入访谈、对管理式医疗专业人员进行全国性调查以及对专家进行共识性调查。确定的生物标志物检测未满足需求的领域包括教育、指南和方案、及时性、流程以及公平性。管理式医疗专家和其他利益相关者提出了22条最佳实践；其中9条最佳实践达成了共识。这些共识性建议涉及生物标志物检测的订购和检测性能、基于生物标志物检测的治疗决策、生物标志物检测的成本效益以及生物标志物检测获取方面的健康差异。确定了实施这些建议的教育机会和基础设施改进机会。尽管获得了有价值的见解，但仍需要进一步研究以制定质量指标。
