Access to Biomarker Testing

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Biomarker testing is key to unlocking precision medicine.

Biomarkers are often used to help determine the best treatment for a patient, but not all communities are benefitting from the latest advancements in biomarker testing and precision medicine.


Progress in improving cancer outcomes increasingly involves the use of precision medicine. Biomarker testing is an important step for accessing precision medicine including targeted therapies that can lead to improved survivorship and better quality of life for cancer patients. But without action to expand coverage of and access to biomarker testing, advances in precision medicine could increase existing disparities in cancer outcomes by race, ethnicity, income, and geography.

ACS CAN is working to expand insurance coverage of comprehensive biomarker testing. 

biomarker legislation status july 2024

Biomarker testing coverage for all state-regulated plans: AZ, CA, GA, IL, IN, IA, KY, MD, MN, NM, NY, OK, PA, RI, TX 
Biomarker testing coverage for some plans: AR, CO, CT, FL, LA
Legislation introduced: HI, MA, ME, NV, NJ, OH, VT, WA, WV

*Arkansas and Louisiana laws apply to state-regulated private plans  **Florida law applies to Medicaid and state employee health plan. ***Connecticut law applies to Medicaid. 

 

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Colorado | Florida | Massachusetts | Maryland | Maine | Minnesota | Nevada |  New York | Ohio | Oklahoma | PennsylvaniaTexas | Washington

 

Last Updated July 2024

Biomarker testing helps ensure cancer patients get the right treatment at the right time.

It allows doctors to precisely target a specific cancer so patients may not have to undergo more generalized treatments like chemo and radiation that may not work as well for them.

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Latest Updates

October 24, 2024
New Jersey

Today, the Assembly Financial Institutions & Insurance Committee voted to improve New Jerseyans’ access to biomarker testing, advancing Assembly Bill 4163 out of committee. Championed by Assemblymembers Shavonda Sumter, Gary Schaer and Shama Haider, the proposal would ensure biomarker testing is covered by New Jersey-regulated insurance plans, including Medicaid, when medical and scientific evidence shows it would provide a benefit to patients. Advocates now look to the full Assembly to favorably advance Assembly Bill 4163 to the Senate.

October 2, 2024
Hawaii

The American Cancer Society (ACS) released an update this week on breast cancer occurrence and trends in the United States. While the new report finds mortality rates have dropped by 44% since 1989, not all women have benefited from this progress. The report highlighted a continued upward trend in breast cancer incidence with the steepest increase in women younger than 50 years and Asian American/Pacific Islander (AAPI) women of all ages. The release coincides with the American Cancer Society Cancer Action Network’s (ACS CAN) campaign to connect patients with the right treatment at the right time through increasing access to biomarker testing in Hawaii.

October 1, 2024
Pennsylvania

Harrisburg residents and cancer advocates gathered at the Pennsylvania War Veterans’ Memorial Fountain outside of the Capitol building in Harrisburg this evening to honor the lives affected by cancer with a heartfelt display of 270 Lights of Hope bags representing the estimated 27,000 Pennsylvanians who will die from the disease in 2024. The personalized Lights of Hope bags were lined along the fountain, which was lit pink for Breast Cancer Awareness Month, to symbolize the strength, hope and memories of those touched by cancer.

July 1, 2024
Pennsylvania

Today, Governor Shapiro signed House Bill 1754 into law, securing a major win for patients across Pennsylvania. The new law will require all state-regulated health plans, including Medicaid, to cover comprehensive biomarker testing, which will enable more Pennsylvanians to access biomarker testing that can open the door to precision medicine. Targeted treatment can lead to fewer side effects, improved survival, better quality of life and potentially lower costs for patients facing cancer and other serious illnesses.

Access to Biomarker Testing Resources

Biomarker testing is becoming increasingly important for cancer care because it connects the right patient, to the right treatment, at the right time, however insurance coverage of testing varies widely.

ACS CAN conducted a survey of 315 oncology providers examining barriers providers face in performing recommended cancer biomarker testing. The survey found that providers face challenges such as lab turnaround time, patient concerns about out-of-pocket-costs, and insurance coverage of biomarker tests.

Precision medicine in cancer involves targeted therapies which work by interfering with specific cellular processes involved in the growth, spread, and progression of cancer. Treatment with targeted therapy often requires diagnostic testing to identify specific cancer biomarkers. Testing patients for biomarkers is integral to precision medicine in cancer care.