New approaches to the payment and accounting of molecular genetic testing in the compulsory health insurance system of the Sverdlovsk region

• Valery A. Shelyakin
• Dmitry A. Tretyakov
• Andrey S. Khudyaev
• Grigory A. Tsaur

Abstract

The cancer incidence in the Russian population continues to grow. Thus, according to the results of the analysis of state medical statistics data according to form No. 7 “Information on malignant neoplasms”, presented by specialists from the Moscow Research Oncological Institute named after P.A. Herzen, at the end of 2022, the incidence rate of malignant tumors in the country (raw count) as a whole was 425.9 per 100 thousand population. The increase in incidence leads to expected increase in government spending on the treatment of diseases of this profile, their prevention and subsequent rehabilitation: this trend requires new approaches to both determining the need for the volume of oncological care and assessing the objectivity and clinical feasibility prescribed antitumor treatment. For this purpose, in the compulsory health insurance system of the Sverdlovsk region since 2019 molecular genetic testing for the diagnostics of oncological and oncohematological disorders and for the tumor biomarkers identification for the targeted therapy were charged in a volume significantly exceeding the established federal standards. This led to positive impact on certain socio-demographic factors associated with cancer mortality and also increased the purity of prescribing expensive anticancer agents (targeted therapy).

Keywords:malignant neoplasms; molecular genetic testing; compulsory medical insurance; tariffication

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