New Survey: Top Barriers to Biomarker Use in Cancer Care Include Coverage and Cost Concerns

December 2, 2021

WASHINGTON, D.C.—December 2, 2021—The American Cancer Society Cancer Action Network (ACS CAN) released new survey data today examining some of the most common barriers providers face in performing recommended cancer biomarker testing. The survey of 315 oncology providers found lab turnaround time was the greatest challenge to biomarker testing (41%), followed by patient concerns about out-of-pocket costs (39%) and insurance coverage of biomarker tests (37%).

The majority of providers (68%) reported that most or all of their patients who should be getting biomarker tests—which are often required in order to select targeted cancer therapies—were getting tested. However, 66% report that insurance coverage for such testing is a significant to moderate barrier to appropriate testing and 46% report needing to seek prior authorization from insurers often or always before testing.

Biomarker testing can be important throughout a patient’s course of treatment, with providers reporting ordering testing at the time of initial diagnosis, at recurrence or metastasis and for monitoring and drug response. 

“While tremendous progress has been made in providing patients access to essential biomarker testing, it’s also important that such testing is readily available and is not delayed by coverage barriers,” said Lisa Lacasse, president of ACS CAN. “Saving more lives from cancer is increasingly reliant on precision medicine and personalized treatments. We need to do all that we can to ensure policies keep pace with innovation and patients can benefit immediately from the rapid pace at which cancer care is advancing.”

Eighty-nine percent of providers surveyed said biomarker testing makes it easier for them to make more informed treatment recommendations and 85% agree that improving access to biomarker testing can help improve health equity.

Biomarker testing has been required or recommended for more than half of the 62 cancer drugs introduced in the last five years and research continues to show that cancer patients who receive biomarker-driven targeted cancer therapy have improved outcomes.

“Without access to comprehensive biomarker testing, the advances in cancer care that precision medicine provides cannot be realized on a large scale,” said Lacasse. “That’s why ACS CAN is committed to making sure recommended biomarker testing is covered for all cancer patients who could benefit.”

ACS CAN recently worked with Illinois legislators to pass a first-in-the-nation law expanding insurance coverage of biomarker testing, including for those covered by Medicaid, and supported similar legislation that passed in Louisiana. ACS CAN is working with a broad coalition of partners in other states to support legislation to expand coverage of comprehensive biomarker testing.

“We are very encouraged by the enthusiasm we are receiving from legislators and policy makers across the country about this important issue and look forward to continuing to educate lawmakers, patients and the public about the need for biomarker testing,” said Lacasse.

The survey of was conducted July 22 to October 8, 2021.

Read full survey results.

Funding for the survey was provided by Amgen, Bayer, EMD Serono, Foundation Medicine, NeoGenomics, and Pfizer.

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