Increasing Access to Biomarker Testing

Specialized testing can help doctors ensure they are getting the right treatment to the right patient at the right time -- but not everyone has access.

This testing, called “biomarker testing”, identifies markers or mutations in a patient’s cancer cells. The results of biomarker tests can help determine the best treatment plan for a specific patient, leading to improved survivorship and better quality of life.

Unfortunately, not all cancer patients have access to these groundbreaking tests. Many insurance plans won’t cover this testing, even when it’s supported by medical and scientific research.

That is why we are asking Connecticut lawmakers to require insurance plans cover biomarker testing when it’s needed.

What is biomarker testing?

Biomarker testing helps get the right treatment to the right patient at the right time. Progress in improving health outcomes increasingly involves the use of precision medicine, which uses information about a person’s own genes or proteins to prevent, diagnose or treat various diseases and chronic illnesses like cancer. Biomarker testing is an important step to accessing precision medicine which includes targeted therapies that can lead to improved survivorship and better quality of life for patients battling diseases and chronic illnesses like cancer.

Biomarkers are often used to help determine the best treatment for a patient. A “biomarker” is a sign of disease or abnormal function that can be measured in blood, tissue, or bodily fluid. Biomarker testing is the analysis of a patient’s tissue, blood, or fluid biospecimen for the presence of a biomarker.

Biomarker testing is increasingly important for cancer care – and for the treatment of other diseases. Thirty-seven of the 62 oncology drugs launched in the past five years require or recommend biomarker testing prior to use.

Expanding access to biomarker testing

Despite the growing importance of biomarker testing in personalized medicine, significant barriers to biomarker testing persist,

A significant percentage of cancer patients and survivors do not receive biomarker testing because it is not covered by their insurer or the out-of-pocket costs would be too high. A recent study found that 32% of New Yorkers are covered by plans that have more restrictive coverage than what is recommended by the National Comprehensive Cancer Network® (NCCN) guidelines for four common cancers. This means a significant number of New Yorkers and a significant number of cancers are being left out.

There is currently limited and disparate access to biomarker testing. According to a recent ACS CAN, Survivor Views survey of cancer patients and survivors, 29% of patients who discussed the need for biomarker testing with their doctor did not receive this testing because it was not covered by their insurer or the out-of-pocket costs would be too high.

Not all communities are benefitting from the latest advancements in biomarker testing and precision medicine. Communities that have been marginalized including communities of color and individuals with lower socioeconomic status are less likely to receive biomarker testing.

People in rural communities and those receiving care in nonacademic medical centers are also less likely to benefit from biomarker testing.

Share your Story

A patients story is the most impactful way to convey the importance of biomarker testing. Do you have a story to share? If you are a patient or survivor battling a disease or chronic illness like cancer who has had biomarker testing and benefitted from a targeted therapy because of that testing, please fill out this survey form and share your story with us.