Reports from University of Washington Describe Recent Advances in Managed Care (Payer Preferences and Willingness to Pay for Genomic Precision Medicine: A Discrete Choice Experiment)

2020 APR 29 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Researchers detail new data in Managed Care. According to news reporting originating from Seattle, Washington, by NewsRx correspondents, research stated, “Although precision medicine using genetic information offers significant promise, its uptake and eventual clinical and economic impacts are uncertain. Health care payers will play an important role in evaluating evidence and costs to develop coverage and reimbursement policies. To elicit U.S. health care payer preference for genomic precision medicine to better understand trade-offs among clinical benefits, uncertainty, and cost.”

Financial supporters for this research include NIH Common Fund, NIA via the Personalized Medicine Economics Research (PriMER) project.

Our news editors obtained a quote from the research from the University of Washington, “Using key informant interviewer discussions (N = 6 payers), we identified 6 key attributes of genetic tests important to payers: type of information the test provides (screening vs. treatment prediction), probability that the member has an informative genetic marker, expert agreement on changing medical care based on the marker, quality-of-life gains, life expectancy gains (with statistical uncertainty), and cost to the plan. We designed a stated preference discrete choice experiment using these attributes and administered a web survey to a sample of U.S. health care payers. We used effects coding and analyzed the data using an error component mixed logit modeling approach. The survey response rate was 58% (150 participants completed the survey). Approximately 53% of respondents had previous experience evaluating genetic tests for reimbursement, and 85% had more than 5 years of health care decision-making experience. Payers valued improvements in quality of life the most (marginal willingness to pay [mWTP] of $1,513-$ 6,076), followed by medical expert agreement on the treatment change (mWTP of $ 2,881-$ 3,489). Payers placed a relatively lower value for genetic tests with lower marker probability (mWTP of $ 2,776 for highest marker probability to $423 for lowest marker probability). Payers mWTP was lowest for resolving uncertainty in quality of life (mWTP of $1,513-$2,031) and life expectancy gains ($ 536-$ 1,537). Payers exhibited a strong preference for genetic tests that improved quality of life, had high expert agreement on changing medical care, and increased life expectancy.”

According to the news editors, the research concluded: “These findings suggest that payers will need evidence of clinical utility to support coverage and reimbursement of genomic precision medicine.”

For more information on this research see: Payer Preferences and Willingness to Pay for Genomic Precision Medicine: A Discrete Choice Experiment. Journal of Managed Care & Specialty Pharmacy, 2020;26(4):529-537. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

The news editors report that additional information may be obtained by contacting J.J. Carlson, University of Washington, Comparat Hlth Outcomes Policy & Econ Choice Inst, School of Pharmacy, Seattle, WA 98195, United States. Additional authors for this research include D.S. Dhanda, D.L. Veenstra, A. Basu and D.A. Regier.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.18553/jmcp.2020.26.4.529. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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