Moving into the Next Decade of NIH Funding: UCSF TRANSPERS Receives $2.3M in NCI Funding to Study Economics and Decision-Making for Precision Medicine

New genetic testing panels and sequencing-based tests have the potential to transform healthcare. The use of “multigene tests” is growing rapidly, particularly for cancer. However, these tests raise questions such as:

• Will multigene tests be covered by insurers when appropriate so that there is neither overuse nor underuse because of cost?
• How will coverage, reimbursement, and out-of-pocket price for multigene tests influence testing practices across diverse providers and clinical sites, particularly in safety net settings?

The UCSF Center for Translational and Policy Research on Personalized Medicine (TRANSPERS), funded by NIH for the past decade, will be continuing its commitment to objective analyses of these issues into the next decade. TRANSPERS has received a grant from the National Cancer Institute to examine the influence of economic factors on decision-making for multigene tests broadly and for cancer-related indications specifically. To answer these questions, TRANSPERS has partnered with collaborators from Stanford, American Institutes for Research, Palo Alto Medical Foundation, and Centers for Business Models in Healthcare.

The study has two aims:

1. WHY tests are covered or not covered and HOW this is changing over time?
2. HOW does coverage, price, & reimbursement influence testing decisions & practices?

We will answer these questions by:

1. Conducting in-depth analyses exploring why tests are covered/not covered, using data from payer interviews and a Symposium that engages payers, clinicians, and researchers,
2. Conducting semi-structured interviews with genetic counselors, physicians, and clinic administrators in seven sites, including safety net and community clinics, to examine how economic factors influence testing in actual practice across providers and sites, and
3. Conducting a national survey of genetic counselors to obtain quantitative data on how they believe that economic factors influence testing decisions and practices.

About TRANSPERS

TRANSPERS is located in the Department of Clinical Pharmacy at UCSF and affiliated with the Philip R. Lee Institute for Health Policy Studies and Helen Diller Family Comprehensive Cancer Center. For more information, contact [email protected].