ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2018
From the Past to the Present: Insurer Coverage Frameworks for Next-Generation Tumor Sequencing.
Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Financing and Reimbursement Models for Personalised Medicine: A Systematic Review to Identify Current Models and Future Options.Applied health economics and health policy · 2022Pooled it
- Real-World Actionability Analysis of Comprehensive Genomic Profiling Versus Single/Small-Gene Panels.Oncology and therapy · 2026Article
- Commercial price variation in precision oncology testing across US hospitals.Health affairs scholar · 2026Article
- Urine as a source of biomarkers and biological knowledge in chronic kidney disease.Nature reviews. Nephrology · 2026Review
- Distributional Cost-Effectiveness Analysis in Genomic Medicine: Considerations for Addressing Health Equity.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2025Article
- Implementation of Cancer Genomics in the United States: Views of Payers and Other Stakeholders on Challenges and the Role of Payers in Solutions.JCO precision oncology · 2025Article
- Paving the path for implementation of clinical genomic sequencing globally: Are we ready?Health affairs scholar · 2024Article
- Article
- Perspectives of private payers on multicancer early-detection tests: informing research, implementation, and policy.Health affairs scholar · 2023Article
- Effective and Efficient Delivery of Genome-Based Testing-What Conditions Are Necessary for Health System Readiness?Healthcare (Basel, Switzerland) · 2022Article
- Impact of Integrated Genetic Information on Diagnosis and Prognostication for Myeloproliferative Neoplasms in the Next-Generation Sequencing Era.Journal of clinical medicine · 2021Article
- The Community Oncology and Academic Medical Center Alliance in the Age of Precision Medicine: Cancer Genetics and Genomics Considerations.Journal of clinical medicine · 2020Review
- Private Payer and Medicare Coverage for Circulating Tumor DNA Testing: A Historical Analysis of Coverage Policies From 2015 to 2019.Journal of the National Comprehensive Cancer Network : JNCCN · 2020Article
- Use of Real-World Evidence in US Payer Coverage Decision-Making for Next-Generation Sequencing-Based Tests: Challenges, Opportunities, and Potential Solutions.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2020Review
- Insights From a Temporal Assessment of Increases in US Private Payer Coverage of Tumor Sequencing From 2015 to 2019.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2020Article
- Educational and Ethical Considerations for Genetic Test Implementation Within Health Care Systems.Network and systems medicine · 2020Review
- New Medicare Coverage Policy for Next-Generation Tumor Sequencing: A Key Shift in Coverage Criteria With Broad Implications Beyond Medicare.JCO precision oncology · 2018Article
- From complexity to clarity: A perspective on personalized spine care through genetic, psychosocial, and technological advancements.Journal of craniovertebral junction & spineReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
Next-generation sequencing promises major advancements in precision medicine but faces considerable challenges with insurance coverage. These challenges are especially important to address in oncology in which next-generation tumor sequencing (NGTS) holds a particular promise, guiding the use of life-saving or life-prolonging therapies. Payers' coverage decision making on NGTS is challenging because this revolutionary technology pushes the very boundaries of the underlying framework used in coverage decisions. Some experts have called for the adaptation of the coverage framework to make it better equipped for assessing NGTS. Medicare's recent decision to cover NGTS makes this topic particularly urgent to examine. In this article, we discussed the previously proposed approaches for adaptation of the NGTS coverage framework, highlighted their innovations, and outlined remaining gaps in their ability to assess the features of NGTS. We then compared the three approaches with Medicare's national coverage determination for NGTS and discussed its implications for US private payers as well as for other technologies and clinical areas. We focused on US payers because analyses of coverage approaches and policies in the large and complex US health care system may inform similar efforts in other countries. We concluded that further adaptation of the coverage framework will facilitate a better suited assessment of NGTS and future genomics innovations.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.