Abstract
The question of “what is reasonable and necessary” is not foreign to clinical practice. Considering what is reasonable and doing what is necessary are the next steps, once a diagnosis is made. In most cases there are no one-size-fits-all solutions, and decisions typically have to be adapted to the individual’s clinical status and medical history, among the available therapeutic options, based on a personalized medicine approach. This is somewhat distinct from the precision medicine model, which pre-requires tools and technologies for a precise qualification of the clinical status of patients such as, in the case of Alzheimer’s disease (AD), establishing the presence of an abnormal cerebral burden of Amyloid and Tau, in addition to evidence of Neurodegeneration, based on the AT[N] biomarker signature. There is a vast diversity in the availability of such technologies in different countries around the globe, or among hospitals within a given region. At a macro level, “what is reasonable and necessary” is also an essential dilemma for governmental and other healthcare providers and payers. In this issue, Linus Jönsson and Anders Wimo discuss the range of issues and considerations regarding reimbursement, as they attempt to address the question of “what is reasonable and necessary” from a health economic perspective.[...]