Connecting the dots between some Linked In articles and journal publications in the last several days.
PREVENTION - Does it save money?
The general answer is probably no, and the general better-question is "is prevention money well spent?"
At Linked In, Peter Neumann raises this topic here. His point is, we should evaluate health case services on health-value created per cost, not only on whether absolute dollars are saved.
He directs readers to a new article in JAMA Forum, by Baicker and Chandra, "Can Prevention Save Money?" Here. They argue that Cost/QALY and similar approaches are better than asking "does it save money?"
I made a comment that we got here in part because of too many years of glib assertions (and not by economists) that "prevention saves so much money."
On the same themes, see an April 7 Op Ed in the Washington Post by Ward & Goldman about Medicare's mistake in not covering GLP-1 drugs. The article argues they are cost-reducing and some readers might imply cost-saving ("wide access would have extraordinary benefits to society...benefits would pour through the economy." But many editorial factors are included like future generic pricing.
GENOMICS - The Insourcing / Outsourcing Question
A few weeks ago, Robert Boorstein wrote an article at Linked In about the perpetual debate about insourcing and outsourcing genomics - here. His point, insourcing investments still need to be made prudently.
In-House MRD?
I was reminded of Boorstein's points when I saw a new article on Linked IN from Decibio's Megan Nacar. It features Decibiol's data for the growth and diversity of in-house minimal residual disease testing (MRD). See their 3-page open access PDF here. This expansion will only be encouraged (unleashed) by the demise of the FDA LDT regulation.
(I'm not sure exactly how this works reimbursement-wise, as there are no general CPT codes nor general reimbursement policies for MRD, and MolDx seems to cover MRD only from large labs (e.g. Nataera.))
Genomic TAT?
But pair these citations with a new article (?abstract) by Wang et al. in JNCCN on biomarker turnaround time in US patients with NSCLC - here. Using Flatiron records, they find that in a sample of 34000 patients, NGS TAT ran to 3 weeks by 2023. "Use of NGS increased tunaround time" and "TAT has stagnated and remains suboptimal."
(Re TAT and insourcing, see also Dowdell 2024.)
