Payer Coverage Policies of Tumor Biomarker and Pharmacogenomic Testing

March 24, 2023

Biomarker testing is key to unlocking precision medicine and improving cancer outcomes, however not all individuals are benefiting. In a survey of over 300 oncology providers, 66% reported that insurance coverage for biomarker testing is a moderate or significant barrier to appropriate testing for their patients. Additionally, 91% indicated that they consult clinical practice guidelines in their decision to recommend or order biomarker testing. Coverage for guideline-recommended biomarker tests is not universal and can be a barrier to cancer patients accessing treatments that can lead to improved survival and quality of life.