New Legislation Helps Deliver Appropriate Biomarker Testing to More Cancer Patients When and Where They Need It
Currently, there is a significant divide between the promise of precision medicine and how equitably new innovations are applied to each cancer patient’s treatment journey. Our guests Hilary Gee Goeckner (Director of State and Local Campaigns for the American Cancer Society's Cancer Action Network), and Kristine Ashcraft (founder and President of YouScript and member of ACS CAN task force) are actively working to close that gap. They are champions of the ASC CAN effort to pass legislation across the US to expand insurance coverage of evidence-based biomarker testing for cancer patients. In this episode of the Precision Medicine Podcast, they explain why it’s so important.
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Because biomarker testing is a complex topic, host Karan Cushman kicks off the episode by asking our guests to define the different types and their respective benefits. Hilary begins by explaining genetic testing and how results offer a view into someone’s risk for developing cancer. She continues through diagnostic biomarker testing which can help match patients with the right treatments. Kristine then introduces pharmacogenomic/pharmocogenetic testing which looks at the genetic variability of how patients respond to drugs.
It’s clear that testing offers a wide range of benefits and having biomarker test results up front can support clinicians in making more precise treatment decisions as well as modifications to drug selections and dosing based on a patient’s individual profile. But our guests remind us that many underserved patients are less likely to receive guideline-indicated biomarker testing for a variety of reasons. Hilary walks through those challenges including a lack of patient awareness, a plethora of new evidence, physicians not being clear on the clinical practice guidelines for testing, variance in hospital policies about who gets tested as well as insurance coverage and the cost of testing. Most importantly, however, are the significant gaps between standard of care and guideline-recommended best practices and what insurers are actually covering in biomarker testing for cancer patients.
With more targeted treatments becoming available, disparities could increase if precision medicine stakeholders don’t take action to make sure everyone who is a candidate has access to testing.
This is why one of the nation’s leading cancer advocacy organizations, ASC CAN, stepped in and worked with a diverse range of partners across patient and provider groups to develop legislative language that could be used in the states to align insurance coverage policies with the latest evidence.
To date, 20 states have enacted legislation requiring coverage of biomarker testing for diagnosis, treatment management and monitoring of a disease or condition. The legislation typically addresses both state-regulated and private insurance plans. Kristine points out that under the Right Drug Dose Now Act of 2024, it is suggested that EHRs should be upgraded to ensure appropriate biomarker testing is happening at every level. But she says, clinical decision support tools are needed to make it easier for overworked clinicians to test according to current guidelines, which are always changing. She and Hilary also share patient stories that help explain how biomarker testing can change the outcome for cancer patients.
We hope you will tune in to the entire episode and walk away with a little more insight about the progress of precision medicine in America today.
For patient stories that offer a deep dive on the impact of biomarker testing in specific disease areas such as lung, breast and colorectal cancer tune in to episodes 51, 53 and 60. To learn more about the biomarker legislation progress in your state and the ASC CAN mission, visit fightcancer.org.
Download the full transcript of the episode here (pdf).
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About Our Guests
Hilary Gee Goeckner, MSW
Director of State and Local Campaigns, American Cancer Society Cancer Action Network (ACS CAN)
Hilary leads work with ACS CAN staff and coalition partners across the country to improve access to comprehensive biomarker testing, clinical trials, fertility preservation and other health care access issues. Prior to this role, Hilary served as the Kansas government relations director for ACS CAN. Before joining ACS CAN, Hilary served as director of health policy at Kansas Action for Children. She holds a bachelor’s degree in anthropology and global health from Williams College and a master’s degree in social work from Boston College.
Kristine Ashcraft
Founder and President of YouScript
Kristine has worked in pharmacogenomics since 2000 and was named one of the 25 leading global voices in precision medicine. She is the Founder and President of YouScript, an award-winning clinical decision support tool that has integrated PGx-guided personalized prescribing in the clinical workflow for over a decade. Kristine has 25+ years of experience in various C-level, board, customer success and business development roles. She has authored multiple publications on the clinical and economic benefits of pharmacogenomic testing and serves on numerous PGx advisory groups including the STRIPE Steering Committee, the FDA collaborative community for pharmacogenomics, CPIC, and the American Cancer Society Cancer Action Network PGx task force. Kristine is committed to catalyzing the adoption of precision medicine.