IVDT_In Vitro Diagnostics Technology

IVD Technology, November/December 2012

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PATIENT-DATA MANAGEMENT Economic Motivations Advancements in the availability of POL and PST diagnostics are the result of technical progress and changes in the larger manufacturing and software development landscape. A lag in initial adoption is caused, in part, by the uncertainty with which patients and physicians approach new devices, but also by the revenue limits of a new device. However, long-term economic motivations will drive increased adoption of POL and PST modalities. Ten such considerations are presented here. 1. PCS mailed to a laboratory have the lowest sample-collection cost. values (e.g., HbA1C) for the popu- lations they manage. Access to cheap ways of generating this data may be attractive to accountable care organi- zations (ACOs) and other groups. 5. POL testing may off er additional revenue for physicians and may off er self-pay options for rapid diagnos- tics (such as strep tests, HIV tests, and diabetes checkups), allowing individual practices to compete with Minute Clinic-type care centers. 6. To control healthcare costs and improve outcomes, patients will have to become more involved in their care. Diagnostic trends have traditionally been a powerful tool for educating patients. Long-term economic motivations will drive increased adoption of POL and PST modalities. Capital equipment and maintenance cost is concentrated at just a few processing centers. While POL- based tests will remain important and cost-eff ective for a few urgent tests (such as acute infections and pregnancy), payers ultimately will encourage migration to the cheapest suffi ciently accurate option. 2. Th e clinical benefi t of interven- ing sooner or more appropriately is likely to stem complications from acute conditions or off er improved control of chronic conditions, result- ing in lower costs of care. 3. Patients may comply better with routine testing if they do not need to schedule an appointment. Although higher utilization may represent more cost, the diagnostic informa- tion has the value of potentially pre- venting a higher-cost complication. Better compliance alone may prompt payers or disease-management com- panies to reimburse for PST or PCS. 4. Clinicians who receive some value-based reimbursement (pay- for-performance or P4P) will be accountable for changes in testable 7. Employers, payers, and disease- management companies will opt for tele-health options that involve patients on a daily basis and provide more real-time control over disease progression, without the need for an offi ce visit. consumer packaged goods. 10. Pharmaceutical companies will use physician offi ce tests and PST to reduce label risk by screening or monitoring for appropriate popula- tions. Th ey will use results to iden- tify potential trial participants, or share data with physicians to help them improve aggregate health sta- tistics in their patient panels. Impact on IVD Industry To lower the costs associated with the burden of managing chronic diseases, the patient's role is chang- ing. IVD manufacturers that adapt to the new patient role by making consumer-friendly devices or simpli- fying sample collection will remain competitive. Ultimately, payers will incentivize care-delivery models to trust patients, devices, and services, while physicians will need to be con- vinced that PST and PCS tests deliver accurate results. As this challenge is met and these trends are realized, patients will receive optimized care at an economy of scale. References 8. Flexible spending accounts, health clubs, and employers will opt for fi tness, weight, and nutrition track- ing as well as consumer diagnostics as a motivational tool. Combined with "gamifi cation" of these tools, employers will use these strategies to improve health, work effi ciency, and costs. We are already seeing employ- ers give pedometers to employees, for example. 9. PST and POL-type services will have increased retail presence, as large stores try to build their health footprints. Stores will help patients with reimbursement or off er benefi t programs themselves. Data from purchases, on-site testing, and even devices sold under subscription agreements will be used to optimize advertising and promotion of health- appropriate food, clothing, and other 28 IVD TECHNOLOGY | NOVEMBER/DECEMBER 2012 1. Hamacher Resource Group, 2011. 2. AJ Farmer, et al., "Meta-analysis of individual patient data in randomised trials of self moni- toring of blood glucose in people with non- insulin treated type 2 diabetes," BMJ 2012; 344: e486. 3. HE Bloomfi eld, et al., "Meta-analysis: Eff ect of Patient Self-Testing and Self-Management of Long-Term Anticoagulation on Major Clini- cal Outcomes," Annals of Internal Medicine 154 (2011): 472-482. 4. L Saxon, TedMED 2012 talk. Retrieved from Internet at http://youtu.be/e_NZnG- 3ClbU. IVD Bryce Sady is a senior con- sultant with Scholz Consult- ing Partners LLC, an IVD con- sulting group. He specializes in diabetes, chronic disease, mHealth, medical commu- nications, and software. He can be reached via e-mail at bryce@scholzcp.com. Manfred Scholz, PhD, MBA, is president and principal consultant at Scholz Con- sulting Partners LLC. He can be reached via e-mail at ms@scholzcp.com. ivdtechnology.com

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