Report shows insurance coverage of biomarker testing has not kept up with innovation

PR Newswire

WASHINGTON, Sept. 29, 2020

LUNGevity Foundation and American Cancer Society Cancer Action Network report indicates some improvement but substantial gaps still exist for many patients

WASHINGTON, Sept. 29, 2020 /PRNewswire/ —┬áLUNGevity Foundation, the nation’s premier lung cancer-focused nonprofit organization, in partnership with the American Cancer Society Cancer Action Network (ACS CAN), issued a report today analyzing private payer health insurance coverage of biomarker testing for non-small cell lung, colorectal, breast, and prostate cancers. The study serves as an update to a similar review of health care coverage issued by both organizations in 2018.

LUNGevity Foundation logo (PRNewsfoto/LUNGevity Foundation)
LUNGevity Foundation logo (PRNewsfoto/LUNGevity Foundation)

Since 2015, LUNGevity has been working to ensure that all advanced-stage non-small cell lung cancer patients have access to comprehensive biomarker testing at diagnosis, progression, and recurrence, and have the results before making treatment decisions. LUNGevity defines comprehensive biomarker testing as a multiplex panel (also referred to as a multi-gene panel in the report, such as a Next Generation Sequencing panel) to detect multiple mutations including, at a minimum, EGFR, ALK, ROS-1, BRAF, NTRK, RET, MET, HER-2, KRAS, and an immunohistochemistry test to measure levels of the protein PDL1.

Limitations in health care insurance coverage often affect access to these vital advances, which leads to disparities in treatment. The report found that private payer health care coverage is more prominent for single-gene tests. However, health insurance companies are still slow to cover targeted multiplex panels and other forms of testing, such as minimally invasive liquid biopsies, also known as blood-based biomarker testing.

“LUNGevity is proud to partner with ACS CAN on this study as part of our ongoing commitment to improving the lives of cancer patients,” explained LUNGevity Senior Director of Public Policy Initiatives Kristen