Last year we released a blog post on 5 recent Payer trends in Diagnostics. What are the latest developments? Check out this short summary and the video teaser
1. Growing appetite for diagnostics health technology assessment in Europe
EUnetHTA, the European Network for Health Technology Assessment have released or is currently working on four diagnostics related assessments in colorectal cancer, diabetes, antibiotic prescribing and in early breast cancer.
UK’s National Institute for Health and Care Excellence (NICE) also published an evidence-based diagnostics guidance on Tumor profiling tests (EndoPredict, Oncotype DX Breast Recurrence Score, Prosigna, MammaPrint and IHC4+C.) to guide adjuvant chemotherapy decisions in early breast cancer.
2. Joint (regulator-payer) evidence reviews and scientific advice to MedTech manufacturers gain further momentum in the US
Building on the lessons learned through the Parallel Review Program, in 2016 the FDA launched the voluntary Private Payor Program. Through this initiative manufacturers can receive joint feedback from the regulator, private payers and health technology assessors to develop a more efficient evidence generation plan. CareFirst BlueCross BlueShield and United Health Group recently joined the growing list of participating US and international private payors, HTA groups (Current members: BlueCross BlueShield Association, Duke Evidence Synthesis Group, ECRI Institute, Humana, Kaiser Permanente, and the National Institute for Health and Care Excellence (NICE).
3. Payers start to embrace Digital Health
Health insurance companies and public payers more and more embrace digital health. The following three examples show the growing engagement in frameworks, coverage and investment:
NICE has recently published its Framework on Digital Health Technologies from the required clinical evidence perspective.
Health insurer, Cigna Corp. committed $250 million to invest in promising startups and growth-stage companies mainly in data, analytics and digital health.
Centers for Medicare and Medicaid Services (CMS) issued three new CPT codes to reimburse remote patient monitoring, embracing the importance of mHealth, telehealth.
What other major payer trends do you see in the diagnostics, digital health? Please comment