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Special Interview with Andy Fish, Executive Director of AdvaMedDx

Original article featured on Slone Partners.

On Becoming CEO leaders in the cutting-edge diagnostics space share how their careers developed and the goals and aspirations that motivate them.
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Andy Fish is the executive director of AdvaMedDx, an organization that advocates for the power of medical diagnostic tests to promote wellness, improve patient outcomes, and advance public health in the United States and abroad.

His advocacy organization represents over 75 member companies that produce innovative diagnostic tests performed in laboratories, at the hospital bedside, in doctor’s offices, in medical clinics, and in the home. These tests facilitate evidence-based medicine, improve quality of care, promote wellness, and enable early detection of disease. And, since they ultimately influence as much as 70% of health care decision making, they often reduce health care costs.

As technology advances, a new generation of diagnostics testing that provides insights at the molecular level is delivering on the promise of personalized medicine. Andy Fish works daily with legislators and company leaders to make sure that the industry keeps moving in that direction.

In diagnostics, what do you think needs the most attention in terms of advocacy?


Andy Fish:
Our role as a trade association is to essentially clear the way as far forward as we can for the entire industry to bring its technologies and advances for patients into the health care system.

A couple of issues are really critical for this industry going forward. Regulatory issues are always with us. We are in a constant dialogue with FDA and Congress to make sure the regulatory system keeps pace with technology development and science and continues to expedite clearance and approval as much as possible, while still maintaining a balance with patient safety…

What I’ve seen change over the last two to three years is a growing recognition that an even bigger challenge for industry is payment. In other words, are these products really being disseminated as quickly as they should be for optimum patient care? And in our health care system, are diagnostics being paid for at a level that’s commensurate with the value they’re bringing to patients?

That’s fundamentally a challenge right now because the answer in many cases is no.

We’ve just taken steps with Congress last year that would reform Medicare payment for diagnostics, and we’re hopeful that over time that’s going to result in better payment for advanced technologies.

But this is really a problem that goes far beyond Medicare. It’s necessary now for industry to work with the broader health care system…to ensure that diagnostics value is accurately measured, accounted for, and then paid for appropriately.

Is there a quick fix to the payment issue, something that could be enacted within a year?

AF: If someone were “diagnostics czar” and could stroke the pen and do something on the Medicare front, it probably would look something like driving Medicare to a more comprehensive assessment of the returns that diagnostics bring in the health care system and then paying commensurately to that.

But there are a couple of major challenges. There are certainly questions around methodology and health-tech assessment for diagnostics. It’s a really complex field, there is no standard approach to it, so there really needs to be more clarity around how all actors in the space understand the health economic value of diagnostics, which in our view is often under-assessed.

And the other challenge… is that the Medicare system is only part of the puzzle. It really is more complex than being susceptible to a simple policy solution. It’s a case of working with a lot of stakeholders, and to educate and work on better approaches to appropriately value diagnostics.

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