Precision Medicine Solution

How to Get Precision Medicine Solution Using Cutting-Edge Diagnostic Testing

Insurers are calling for a value-based pricing system for pharmaceutical treatments and gradually transitioning to a payment model based on the results. Seeing how many drugs do not reach the desired results, they aim to cover only those treatments that are effective for the patient, thus refusing to pay for unsuccessful attempts. With the help of modern diagnostic testing, the insurance and pharma industries can discover a sustainable and productive solution.

This blog explores the anxieties of stakeholders related to the cost of healthcare treatments depending on their value, the likelihood of personalized medicine diagnostics, and the obstacles faced by the diagnostic testing procedure. It additionally supplies guidance on how stakeholders can join forces to maximize the gain of diagnostics for providers, government, customers, payers, and most notably, patients across public healthcare institutions.

Value-based pricing focuses on the Stakeholders’ Agendas.

High Investments

To pharmaceutical companies, this is an opportunity to realize returns from larger investments. These companies invest anywhere in the range of $1 to $5 billion in the research and development of a new drug from their research and education centre. They need to charge prices that provide not only profits but enable reinvestment for innovation. The excess is used to provide coverage for unsuccessful projects. For private payers, this means reducing costs to ensure sustainability, while government players must deal with additional taxation.

Global Interests

Most pharmaceutical corporations are global companies striving to extend their wares worldwide. To thwart the U.S. from underwriting the expense of drugs in foreign countries, the American government has pressed for medication pricing approaches that lessen any possible variances between countries. Pharmaceutical enterprises must now hit a harmonious balance between the deals reached overseas and internal pricing trends.

Engaged patients

Patients and consumers are increasingly aware of innovations in Indian healthcare, such as liquid biopsies and genetic sequencing. It has prompted the need for more diagnostic testing and treatment. Many individuals face the challenge of rising insurance premiums, co-payments, and deductibles and are not sure which diagnostic tests and treatments will be covered by their healthcare plans.

For the development of value-based pricing to continue, stakeholders, including pharmaceutical companies, consumers, insurance payers, providers, researchers, labs, and suppliers must agree on what’s deemed as ‘value’ and if therapies can truly achieve it. Furthermore, decisions must be made regarding the tests that are made available to providers and consumers and the expected level of accuracy they must meet.

Stakeholders are concerned with the lack of transparency in the pharma industry, stretching from manufacturers and payers to Pharmacies and consumers. Patients are not informed about the prices of medications, having to just pay the co-pay at the drug store, and leaving it to the health plans and Pharmaceuticals to manage their benefits. The actual prices are hidden from employers, patients, and consumers alike, as no entity wants the breakdown of their revenues to be exposed. It makes total transparency complicated to achieve.

Nonetheless, transparency could increase at a rapid rate. Unhappily, improvements are rarely brought forth by those within an industry. Conversely, fresh newcomers, carrying remarkably disruptive business plans, enter a market. These innovators take away custom from traditional companies, making them change, similar to how online travel sites ousted travel agents and digital shopping outshined physical stores.

Furthermore, there is another situation prompting increased transparency and value-based pricing – namely, sophisticated diagnostics. As opposed to the usual, “one-size-fits-all” approach to prescribing, precision medicine offers an alternate solution. Advanced diagnostics, therefore, has the purpose of offering the correct treatment to the appropriate patient at the opportune time, honing in on those most likely to benefit from a certain therapy.

Precision medicine is revolutionary for reducing healthcare costs in public healthcare domain – eliminating costly false positives, inappropriate treatments, and excessive/inadequate dosage. In addition, fewer adverse drug events due to improper prescriptions can help cut down on hospital visits, and subsequently enabling a greater likelihood of successful outcomes. With the use of precision medicine, the era of trial-and-error treatment may soon be over.

Understanding Diagnostic Testing Outlook

Diagnostic testing offers upsides and downsides even though it has opened new doors to therapies and treatment. The progress, however, has been accompanied by an increase in drug prices because of investments in Research and Development by pharmaceutical companies investing heavily in R&D. While clinical trials have been shortened in duration with the assistance of such tests, their related costs are still prohibitive.

With advanced technologies such as next-generation sequencing, the high demand is offset by high costs. If these tests are to be made available at a lower cost, labs must become creative in their approach by constructing gene panels efficiently, streamlining workflow, and assessing employee proficiency.

When compared to studies diagnostic tests are quick, small, in size, and affordable to conduct. They provide researchers with the opportunity to expand the scope of their studies, which is particularly beneficial for diseases. It gives people affected by these conditions a renewed sense of hope in finding a remedy.

However, these tests come with certain difficulties, as the latest sequencing methods are costly. Research facilities at the research and education centre are looking to introduce improved gene panelling, reliable culturing, and analysing methods and protocols to evaluate skills and workload.

Diagnostic Tests Offer Several Advantages Such As:

Step therapy: The use of high-grade diagnostic tests presents an alternative to ‘fail first therapy’, widely rejected eliminating the need to verify whether a treatment is efficacious, or not. This not only safeguards the costs of administering remedies that may not produce the desired results, but it also lessens the toll of the illness on someone who is already compromised.

Adverse Reaction Spotting: Testing plays a pivotal role in evaluating the potential hazards linked to a patient’s well-being. By identifying those unlikely to benefit from treatment, testing serves as a protective measure against subjecting patients to unnecessary harm. Consequently, healthcare professionals can steer clear of the expenses and complications associated with administering ineffective medication or managing its adverse effects. While testing may not give a confirmed verdict on a drug’s efficacy, it can aid clinical lab technicians in anticipating unfavourable reactions that can lead to expensive hospital stays.

Additionally, diagnostic testing empowers physicians with valuable knowledge about a patient’s drug metabolism, which in turn influences their response to specific medications. Public healthcare institutions can tailor the dosage of a medication based on their understanding, which helps guarantee its safety and effectiveness, for each patient.

 Accelerated Treatment: Diagnostic assessments grant medical professionals a thorough understanding of how to offer fast assistance to those who require it. When diagnosis is expedited, proficient treatment can be administered to the individual in question. This enables healthcare personnel to commence the treatment of cancer before it can progress too far, simultaneously evading any unnecessary and potentially damaging procedures.

Faster Diagnostics – Early Rx Intervention

The character of cancer, especially melanoma, points to the enormous possibility of diagnostic testing. Unlike many diseases, cancer is varied, not homogenous. A single sample taken from a tumour may not adequately represent the whole of the cancer. Furthermore, subsequent mutations may render a therapy effective at one time ineffective down the line.

What is more, dreadful is that cancer can impede the regular working of the immune system. Immunotherapy may set the immune system back on its course, yet have difficulty turning it off again. If this were to happen, it could cause the immune system to target healthy cells in an event called a cytokine storm.

Liquid biopsies offer a future, for cancer diagnostics by detecting cancer biomarkers in fluids before treatment decisions are made. The advantages of tests are manifold; it being a less invasive procedure is patient friendly, reduces the need for surgeries for biopsy samples, facilitate treatment progress monitoring through therapeutic drug monitoring, and help make more precise therapy switches based on evidence. While liquid biopsy is still being validated, experts anticipate that it can provide an understanding of entire cancers and enable faster detection of tumours by tracing circulating tumour cells and DNA fragments in blood leading to earlier diagnosis, and treatment ultimately saving lives.

Bottlenecks and Roadblocks in Diagnostic Testing

When it comes to tests, some factors can lead to variations. These include, The substance being analysed (such as a protein)

Type of sample used (like fixed tissue sections, blood samples, or bacterial cultures)

Technology or platform utilized for analysis (such as immunohistochemistry, next-generation sequencing, or immunoassay)

The location where the test is performed like a lab, doctor’s office or patient’s bedside.

To fully benefit from targeted therapies, it is crucial to use testing in a manner. Optimizing a test may involve considering aspects, like quality control, process improvement, and test performance which can differ depending on the test being conducted.

Factors that can influence are:

  • Physician knowledge and awareness
  • Questions about test quality
  • Sample availability
  • Test availability
  • Test turnaround time
  • Test complexity
  • Reporting complexity:
  • Reimbursement

Solutions for optimizing and accelerating quality Diagnostic Testing

Various measures could be implemented to optimize the performance of diagnostic testing and satisfy stakeholders’ needs. This could include responding to an increased need from clinicians for tests, enlarging the test array with higher accuracy, providing stable payment plans, and making the ordering and reporting of results more transparent.


Clinical organizations such as the International Institute of Innovation and Technology (I3TK) serve to design unique solutions for a variety of ailments. This organization collaborates with patients, their families, healthcare providers, clinical researchers, drug companies, diagnostic centres, insurance companies, and government authorities. They pool together medical diagnostics and treatments, generating a comprehensive strategy to accelerate the treatment process of cancer, neurological disorders, and non-communicable diseases


Stakeholders are enthusiastic to discover the costs linked to a certain treatment approach, including the cost of a  part of a certain therapy in that treatment scheme, the conditions where the therapy is used, and the probability of a positive or negative response or negative consequence. Using advanced analytics on testing and prescription data can generate practicable knowledge on all elements of testing and offer the monetary assessment necessary to certify the cost and value of a therapy. Emerging data analytics inclined to be cloud-based analytics can be used for rapid outcome analysis, cost estimation and plan production. Incorporating artificial intelligence, using real-world proof and anonymized patient-level data; and utilization of real-time analytics will increase precision and accuracy.

Finally, awareness of clinical and business proficiency in therapy might become visible as one portion of a diagnostic test given by a clinician. Even though payers may opt to postpone or restrict payment, diagnostic testing data from various sources will help to guarantee patients get the best treatment accessible. By releasing testing data from different sources, comprising clinical trials and real-world studies, clinicians will gain an understanding of how and where to utilize a test, which will then stimulate the need for testing.

Research and Education Centre

To further develop diagnostic testing, research, and education must be done. Prospective research and cost-effectiveness studies can be organized through research partnerships and the outcomes discussed with healthcare providers and payers. Education programs can be utilized to explain test ordering and as a tool to highlight the purpose, components, advantages, and findings of existing and emerging diagnostic tests.

Support to diagnostic labs

Labs can reap tremendous benefits from utilizing technology, standards, and guidelines to ensure better testing outcomes. However, it is necessary to design standardized protocols to combat existing testing problems such as tissue management, turnaround times, test quality, and results reporting. Technologies that address these issues should be selected and implemented to eliminate the strain of cost and time constraints.

Data must also be made accessible and effective for physicians, patients, insurance companies, and other relevant stakeholders. The lab must provide clear interpretations of test results so that clinicians are enabled to provide proper treatments, and payers can understand the coverage they are offering for the patient’s benefit.

Final Thoughts

With the progression of medical science, diagnosis, and treatment will be uniquely adapted to every individual’s needs, health issue, and the suggested cure. Evaluating the pros and cons of treatments and examinations will facilitate healthcare professionals to come to informed judgments. The shift to personalized medicine puts an emphasis on making sure everyone benefits from those the treatment  provided.


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