Prime Therapeutics Release: Study Indicates a Quarter of Lung Cancer Patients Did Not Receive Pharmacogenomic Testing Prior to Start of Treatment

Published: Nov 30, 2012

ST. PAUL, Minn., Nov. 30, 2012 /PRNewswire/ -- Nearly a quarter of patients taking erlotinib (Tarceva®) for treatment of advanced non-small cell lung cancer (NSCLC) did not receive the recommended pharmacogenomic (PGx) testing prior to the start of treatment, according to a new study by pharmacy benefit manager Prime Therapeutics (Prime), in collaboration with Jonas de Souza, MD, Instructor of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center. The study will be presented December 1, 2012, at the American Society of Clinical Oncology (ASCO) Quality Care Symposium in San Diego.

Guidelines released by the National Comprehensive Cancer Network (NCCN) in March 2011 and ASCO in April 2011 recommend PGx testing for tumor epidermal growth factor receptor (EGFR) mutation in NSCLC patients. The Tarceva (erlotinib) prescribing information shows erlotinib to be effective in treating NSCLC. Patients who had a negative EGFR mutation test did not receive a significant benefit in progression free survival or overall survival.

In the study, researchers reviewed medical claims for nearly 3.4 million members from four Blue Cross and Blue Shield plans to identify patients receiving erlotinib. Researchers then reviewed claims for any current procedure terminology (CPT) code indicating PGx testing in the prior 24 months. From January 1, 2011, to June 30, 2011, 125 members received erlotinib. More than 81 percent of erlotinib claims were for lung cancer, over 14 percent were for pancreatic cancer and 4 percent were for other cancers. They found 60 patients (48 percent) were new erlotinib users and 47 had a lung cancer diagnosis. Of those, 36 (76.5 percent) had a PGx CPT code claim, ranging from four days to 22 months prior.

"Understanding mutations in the cancer can help us better understand the effectiveness of treatments and develop care management programs that will have the greatest impact on the patient," said Pat Gleason, PharmD, FCCP, BCPS, director of health outcomes with Prime. "Simplifying medical coding for pharmacogenomics testing and greater use of guidelines will help us continue to improve care for lung cancer patients."

About Prime Therapeutics

At Prime Therapeutics, people are at the center of all we do and every decision we make. As a leader in pharmacy benefit management, Prime is dedicated to making it easier for our members to obtain more affordable medicines. We leverage our unique connections to deliver programs that lead to the best health outcomes.

Prime's integrated pharmacy benefit management services include claims processing, benefit plan design, network management, clinical program consultation, rebate management, formulary administration, mail-service pharmacy and specialty pharmacy.

Headquartered in St. Paul, Minn., Prime Therapeutics serves nearly 20 million people and is collectively owned by 13 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those Plans. Prime has been recognized as one of the fastest-growing private companies in the nation by Inc. 5000 and as a most engaged workplace by Achievers.

For more information, visit or follow @Prime_PBM on Twitter.

SOURCE Prime Therapeutics

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