Can Genomics Deliver on the Promise of Improved Outcomes and Reduced Costs?: Background and Recommendations for Health Insurers
Marc S. Williams
The increased availability of genetic information has the potential to dramatically change the practice of medicine. Health insurers, in their role of evaluating medical appropriateness while controlling costs, are struggling with the incorporation of the genetic paradigm into clinical practice. Tremendous progress has been made in the understanding of genetic causes of single gene disorders. This has led to more sophisticated diagnostic approaches but, with few exceptions, has not led to innovative therapies. Tremendous sums of money are being spent in the emerging field of pharmacogenomics, but little return on this investment has been seen to this point. The Insurers do not have the luxury to wait for the outcome of this debate. They must act now to analyze the new genetic technologies, and incorporate those that demonstrate value. This will necessitate involving geneticists in technology assessment and utilization decisions, as well as adding these specialists to the provider network. In addition, they will need to partner with educators and researchers to ensure that the next generation of providers is genetically competent, as well as to help establish the evidence base for interventions developed from genetic insight.
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