Payer and Developer perspectives on alternative payment models.

Objective: To understand the use of alternative payment models to address the reimbursement challenges of cell and gene therapies (CGT) in the U.S.A.

Economic Impact of Coverage Expansion for Non-invasive Prenatal Testing Through a Performance-Based Risk-Sharing Agreement.

Background: Harvard Pilgrim Health Care expanded coverage for non-invasive prenatal testing (NIPT) to include all pregnant, single-gestation women aged < 35 years, through a performance-based risk-sharing (PBRS) agreement with Illumina to offset costs from coverage expansion. NIPT analyzes cell-free DNA fragments from a maternal blood sample to screen for fetal aneuploidies and is considered a more accurate screening method than conventional serum biochemical screening and nuchal translucency ultrasound-based approaches.

Objective: This study assessed the impact of NIPT coverage expansion on prenatal screening strategies and payer expenditures.

Are Payers Ready, Willing, and Able to Provide Access to New Durable Gene Therapies?

Objective: To explore payer feedback regarding awareness of new gene therapies, sustainability of current financing mechanisms, unique challenges by payer segment, and need and preference for new financial models.

Study Design: Qualitative interview with standardized interview guide.

Methods: Sixty-minute telephone interviews were conducted with financial decision makers from 15 US payers between August and September 2017.

Clinical decision support for personalized medicine: an opportunity for pharmacist-physician collaboration.

Pharmacogenomics has significant potential to improve the efficacy and safety of medication therapy, but it requires new expertise and adds a new layer of complexity for all healthcare professionals. Pharmacists and pharmacy management systems can play a leading role in providing clinical decision support for the use and interpretation of pharmacogenomic tests. To serve this role effectively, pharmacists will need to expand their expertise in the emerging field of clinical pharmacogenomics.