Report shows insurance coverage of biomarker testing has not kept up with innovation

LUNGevity Foundation and American Cancer Society Cancer Action Network report indicates some improvement but substantial gaps still exist for many patients

 

WASHINGTON, Sept. 29, 2020 /PRNewswire/ -- LUNGevity Foundation, the nation's premier lung cancer-focused nonprofit organization, in partnership with the American Cancer Society Cancer Action Network (ACS CAN), issued a report today analyzing private payer health insurance coverage of biomarker testing for non-small cell lung, colorectal, breast, and prostate cancers. The study serves as an update to a similar review of health care coverage issued by both organizations in 2018.

Since 2015, LUNGevity has been working to ensure that all advanced-stage non-small cell lung cancer patients have access to comprehensive biomarker testing at diagnosis, progression, and recurrence, and have the results before making treatment decisions. LUNGevity defines comprehensive biomarker testing as a multiplex panel (also referred to as a multi-gene panel in the report, such as a Next Generation Sequencing panel) to detect multiple mutations including, at a minimum, EGFR, ALK, ROS-1, BRAF, NTRK, RET, MET, HER-2, KRAS, and an immunohistochemistry test to measure levels of the protein PDL1.

Limitations in health care insurance coverage often affect access to these vital advances, which leads to disparities in treatment. The report found that private payer health care coverage is more prominent for single-gene tests. However, health insurance companies are still slow to cover targeted multiplex panels and other forms of testing, such as minimally invasive liquid biopsies, also known as blood-based biomarker testing.

"LUNGevity is proud to partner with ACS CAN on this study as part of our ongoing commitment to improving the lives of cancer patients," explained LUNGevity Senior Director of Public Policy Initiatives Kristen Santiago. "Although there have been noticeable changes in comprehensive health care coverage since our initial study in 2018, there are still many opportunities for improvement when it comes to biomarker testing. The results of this study will help guide our work to remove barriers to comprehensive biomarker testing."

This project complements LUNGevity's other work to understand the payer landscape, such as the www.LungCancerScore.org report, which analyzed Medicaid coverage of comprehensive biomarker testing in lung cancer as an entryway to accessing precision medicine.

The co-authored report is available here.

About LUNGevity Foundation

LUNGevity Foundation is the nation's leading lung cancer organization focused on improving outcomes for people with lung cancer through research, policy initiatives, education, support, and engagement for patients, survivors, and caregivers. LUNGevity seeks to make an immediate impact on quality of life and survivorship for everyone touched by the disease—while promoting health equity by addressing disparities throughout the care continuum. LUNGevity works tirelessly to advance research into early detection and more effective treatments, provide information and educational tools to empower patients and their caregivers, promote impactful public policy initiatives, and amplify the patient voice through research and engagement. The organization provides an active community for patients and survivors—and those who help them live longer and better lives.

Comprehensive resources include a medically vetted and patient-centric website, a toll-free HELPLine for support, the International Lung Cancer Survivorship Conference, and an easy-to-use Clinical Trial Finder, among other tools. All of these programs are to achieve our vision—a world where no one dies of lung cancer. LUNGevity Foundation is proud to be a four-star Charity Navigator organization.

Please visit www.LUNGevity.org to learn more.

About Lung Cancer in the U.S.

  • About 1 in 16 Americans will be diagnosed with lung cancer in their lifetime
  • More than 228,000 people in the U.S. will be diagnosed with lung cancer this year
  • About 60%-65% of all new lung cancer diagnoses are among people who have never smoked or are former smokers
  • Lung cancer takes more lives than the next three leading cancers (colorectal, breast, and prostate) combined
  • Only 21% of all people diagnosed with lung cancer will survive 5 years or more, BUT if it's caught before it spreads, the chance of 5-year survival improves dramatically

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SOURCE LUNGevity Foundation

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