Trends in prognostic testing

In the past 18 months we have worked on 4 different prognostic tests based on  novel biomarkers in 3 clinical areas; cancer, fibrosis and musculoskeletal disorders.  There seems to be a clear trend towards this approach and the clinicians we spoke to indicated that they expected to see an increase in the uptake of prognostic testing in the medium to long term.  Prognostic testing can impact the choice of treatment, patient management and monitoring, as well managing patient expectations regarding the likelihood of disease recurrence.  What is not clear is how these types of tests are going to be funded; they often have applications in large patient populations and the health economic arguments can be complex.  Technologies employed are also diverse, ranging from existing path lab techniques  to analysis by LC/MS.