How Can Patients Combat the Cost of Sophisticated Blood Tests?

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Topics include: Self-Advocacy and Empowerment and Understanding

Patient Power community member Darrel wants to know how cancer patients can access the necessary diagnostic and genetic testing to receive the most precise care available. Noted clinical trials expert Dr. Richard Schilsky, from the American Society of Clinical Oncology, responds by discussing typical insurance coverage for sophisticated tests and clinical trial research on the best use of genetic profiling and targeted therapies. Community outreach volunteer Cecelia Mann, from The Leukemia & Lymphoma Society (LLS) also shares ways she spreads awareness about clinical trials. Tune in to hear their expert advice.

This is a Patient Empowerment Network program produced by Patient Power. We thank AbbVie, Inc., Astellas, Celgene Corporation, and Novartis for their support.

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Now, where it gets a little bit uncertain is when you get into this sort of large-scale genomic testing where a patient's tumor might be tested for many hundreds of genes not really knowing what you're looking for and not really knowing what you're going to do when you find it.  And that is where you're beginning to bump up a little bit against, research and that's where the insurance companies, sometimes some are reluctant to pay for that kind of testing. 

Now, at least one of those large genomic profiling tests earlier this year was approved by both the FDA and Medicare and now will be reimbursed.  So that's the good news, and I think that's the direction that most insurance companies are heading in. 

One of the things that my organization is doing to try to understand how best to use these tests and how best to use targeted cancer drugs is we're doing our own clinical trial that's available in 20 states around the country, so not the entire country yet, but has already enrolled more than 1200 people on the study over the last two-and-a-half years.  And we're doing this study to understand how this kind of genomic testing is done, what kind of treatment is recommended based on the results of the genomic test and whether or not that treatment actually works.  

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Page last updated on April 18, 2019