The Healthcare Leadership Council brought together a panel of experts on Capitol Hill for a congressional briefing that showcased what the healthcare industry is capable of in the area of personalizing prevention and treatment for the individual patient.
David Liss, representing BioReference Laboratories, provided a timeline of how genetic lab tests are collected and processed, and the role prior authorization plays in being reimbursed for those tests. He noted that there are opportunities for improvement surrounding reimbursement that would allow for better utilization and encourage innovation in the development of precision medicine. Liss also suggested that technology such as electronic health records be used for administrative decision support in addition to clinical decision support in order to save time and money on each prior authorization transaction.
Elizabeth Budde, M.D., Assistant Professor within the Department of Hematology at City of Hope, described how CAR T therapy is changing the lives of patients. She explained that CAR T cells produce better outcomes for patients who have failed standard treatment and that consistency with reimbursement models would help with uncertainty and improve patient access. Dr. Budde stated that the pipeline for new treatments is growing and there are a variety of promising clinical trials in progress.
Andrea Willis, M.D., Senior Vice President and Chief Medical Officer at BlueCross BlueShield of Tennessee, discussed the importance and effectiveness of digital care management and its positive influence on patient behaviors. She noted that the services included support for people outside the walls of care delivery, allowing patients to utilize technology to track and assist with medication adherence, wellness activities and more. Dr. Willis pointed out that with new messaging capabilities, fully engaged patients learn about additional community resources and are then connected with appropriate services that can improve health outcomes.
Eddy Han-Burgess, Epilepsy Prediction and Integrated Analytics Lead at UCB, shed light on how predictive tools and solutions are being developed for patients with epilepsy. He stated that one third of the 3.4 million people with epilepsy will become drug resistant. He described UCB’s development of risk scores to predict the likelihood of drug resistance in order to proactively enable better care. Han-Burgess provided an example of the challenge of connecting brain images to clinical files at other provider practices and concluded that a national patient identifier would assist in connecting patient data for efficient care and better outcomes.
Rachael Fones, Director of Government and Public Affairs at IQVIA, explained how clinical trials and analytics play a role in innovation for individualized patient care. She stated that the more targeted treatment decisions and therapies are driving increased complexity in clinical development, and that utilizing analytics can drive better trials from the start. Fones said that procedures and design features can affect patient burden, and IQVIA is increasing predictability and reducing the length of certain trials with learning algorithms.