CHAIR
:
SPEAKER
(S):
Paul Sheives,
JD,MS (SPKNON), Director for Diagnostics and Personalized Medicine Policy,
Biotechnology Industry Organization (BIO), United States
With a background in molecular biology, regulatory law, & reimb. counseling, Paul heads a Personalized Med. & Diagnostics working group at BIO, which endeavors to foster a positive public policy environment that maximizes the impact of the personalized medicine for the benefit of patients.
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Gary Gustavsen, JR, MS (SPKNON), Manager, Health Advances, United States
Val Guild, (SPKSUP), President, AIM at Melanoma, United States
Laura Housman, MBA,MPH (SPKNON), Vice President, Global Market Access, Novartis Molecular Diagnostics, United States
Description
The future of personalized medicine is dependent upon the development of rational reimbursement and coverage policies. These policies must reflect the real value companion diagnostics play in targeting important breakthrough medical therapies to ensure that patients are receiving the therapy most suited to their specific condition. This session will discuss the following key elements that are critical to ensuring appropriate decisions are taken reflecting the market-based value and importance of diagnostics in patient health and well-being: Working with payers on coverage policies to support appropriate adoption and use of the co-developed diagnostic; working with payers on coding and billing policies to distinguish co-developed diagnostics from tests analyzing the same or similar biomarkers, but which have not been validated or labeled specifically for use with the therapeutic; outreach to customers and treating physicians to explain test-specific coverage and payment policies; plus a case study to illustrate the importance of managing expectations and negotiations with payers/price-setters.