Medical-economic aspects of the use of genomic signatures

摘要

Genomic signatures have been proven to be useful for refining diagnosis and guiding therapy in oncology. They are currently reimbursed in France by the RIHN (Référentiel des actes innovants hors nomenclature) set up by the DGOS (Direction générale de l’offre de soins), rather than by the healthcare system. This process, which is subject to a limited budget, is by its nature, temporary and, therefore, fragile. In addition, the remaining cost for institutions is significant, leading laboratories that perform these tests to finance the bulk of them. In order for these tests to be registered in the NABM (Nomenclature générale des actes de biologie médicale) and to be reimbursed by the healthcare system, medical-economic studies must be presented to the HAS (Haute Autorité de santé). However, these are often lacking. The IGAS (Inspection générale des affaires sociales), the IGESR (Inspection générale de l'education, du sport et de la recherche), and the Ethics and Cancer Committee are calling for a rapid solution to this shortcoming, which is a source of inequality of access to appropriate care.