Private payer coverage policies for ApoE-e4 genetic testing.
Private payer coverage policies for ApoE-e4 genetic testing.
复制标题
DOI：
10.1038/s41436-020-01042-4
复制
发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Phillips KA
中科院分区：
文献类型：
--
作者：
Arias JJ;Tyler AM;Douglas MP;Phillips KA
ApoE-e4 has a well-established connection to late-onset Alzheimer’s disease (AD) and is available clinically. Yet, there have been no analyses of payer coverage policies for ApoE. Our objective is to analyze private payer coverage policies for ApoE genetic testing, examine the rationales, and describe supporting evidence referenced by policies. We searched for policies from the 8 largest private payers (by member numbers) covering ApoE testing for late-onset AD. We implemented content analysis methods to evaluate policies for coverage decisions and rationales. Seven payers had policies with positions on ApoE testing. Five explicitly state they do not cover ApoE and two apply generic pre-authorization criteria. Rationales supporting coverage decisions include: reference to guidelines or national standards, inadequate data supporting testing, characterizing testing as investigational, or that testing would not alter patients’ clinical management. Seven of the eight largest private payers’ coverage policies reflect standards that discourage ApoE testing due to a lack of clinical utility. As the field advances, ApoE testing may have an important clinical role, particularly considering that disease-modifying therapies are under evaluation by the Food and Drug Administration. These types of field advancements may not be consistent with private payers’ policies and may cause payers to reevaluate existing coverage policies.
登录
查看更多内容
影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
DOI：
10.1002/alz.12235
发表时间：
2021-04
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
Sabbagh MN;Cummings J
通讯作者：
Cummings J
DOI：
10.1097/gim.0b013e31821d69b8
发表时间：
2011-06
期刊：
Genetics in medicine : official journal of the American College of Medical Genetics
影响因子：
--
作者：
Goldman JS;Hahn SE;Catania JW;LaRusse-Eckert S;Butson MB;Rumbaugh M;Strecker MN;Roberts JS;Burke W;Mayeux R;Bird T;American College of Medical Genetics and the National Society of Genetic Counselors
通讯作者：
American College of Medical Genetics and the National Society of Genetic Counselors
影响因子：
14
作者：
通讯作者：
--
DOI：
10.1016/j.jalz.2011.03.004
发表时间：
2011-05
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
Jack CR Jr;Albert MS;Knopman DS;McKhann GM;Sperling RA;Carrillo MC;Thies B;Phelps CH
通讯作者：
Phelps CH