Integrating molecular medicine into the US health-care system: opportunities, barriers, and policy challenges.
Scientific support about the concept of using molecular data for risk stratification and tailoring health-care interventions to the individual--a strategy broadly defined as molecular medicine (MM)--is accumulating. Molecular-based health-care technologies are beginning to enter clinical practice, but their use has revealed many scientific, economic, and organizational barriers to the effective delivery of targeted health care. We conducted a qualitative interview study to describe the MM landscape, with an emphasis on eliciting policy recommendations for the field from a broad range of stakeholders in MM and health care. Molecular medicine has widespread support but will require changes in how molecular-based technologies are evaluated, how health care is financed and delivered, and how clinicians and consumers are trained and prepared for its use. In particular, researchers and developers need to become active participants in a variety of clinical integration strategies to realize the promise of MM.
Institute for Genome Sciences and Policy, Duke University, Center for Genome Ethics, Law & Policy, Durham, North Carolina, USA. gelp@duke.edu
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PA
Deverka
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Doksum
R J
RJ
Carlson
D015510:Clinical Medicine / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D005820:Genetic Testing / Q000191:economics / Q000331:legislation & jurisprudence; D033161:Government Regulation; D017408:Guidelines as Topic; D017048:Health Care Costs; D019538:Health Care Surveys; D006291:Health Policy; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D008967:Molecular Biology / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D025202:Molecular Diagnostic Techniques / Q000191:economics; D018579:Patient Selection; D010597:Pharmacogenetics / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D014481:United States