Echoing contentions made by PMC in its most recent white paper, Paying for Personalized Medicine, Barbara L. McAneny, M.D., the immediate past chair of the American Medical Association (AMA) Board of Trustees and a board-certified oncologist/hematologist, has voiced her support for ensuring that future advancements in personalized medicine are considered early in the development of alternative payment models (APMs) that include clinical pathways.

In a recently published article in Inside Health Policy, McAneny points out that clinical pathways and personalized medicine are not mutually exclusive, as long as the pathways are constructed thoughtfully. Pathways with no exemptions, she said, are particularly problematic, because even if a pathway is the right answer 80 percent of the time, “you have patients that aren’t going to fit in the box.”

PMC Executive Vice President Amy M. Miller, Ph.D., agrees. Miller, whose comments appeared alongside McAneny’s in the article, emphasized that payment models incorporating pathways must keep up with the science for any particular disease state.

The comments from McAneny and Miller are part of a broader effort to ensure that the personalized medicine perspective is considered as the health care system explores new, value-based payment paradigms.

In a separate piece recently published by Evidence-Based Oncology, Miller and ML Strategies Director of Health Care Policy & Life Sciences Andrew J. Shin, J.D., M.P.H., contend that if APMs are not thoughtfully constructed they could ultimately discourage investment in personalized medicines that cost more in the short term but can save money in the long run.

“If executed well, these new paradigms could represent a new set of incentives that build on personalized medicine’s progress, improving care coordination and outcomes while controlling costs,” the article reads. “However, if structured inappropriately and without the safeguards necessary to ensure high-quality care, APMs could have unintended consequences that limit patient access to vital services and medications.”

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Christopher J. Wells
Communications Director
Personalized Medicine Coalition