Oncologists Report Barriers to Biomarker Testing, Survey Finds

Biomarker testing has become increasingly important for making informed, personalized treatment decisions for patients with cancer.

However, a new nationwide survey conducted by the American Cancer Society Cancer Action Network (ACS CAN) highlights a range of challenges to biomarker use — most notably, lab turnaround time, the cost of testing, and inadequate insurance coverage.

“While tremendous progress has been made in providing patients access to essential biomarker testing, it’s also important that such testing is readily available and is not delayed by coverage barriers,” Lisa Lacasse, president of ACS CAN, said in a statement.

The survey, conducted between July 22 and October 8, 2021, was published online December 2.

The researchers received responses from 315 oncology providers, most of whom were oncologists (81%), but registered nurses, advanced practice providers, surgeons, pathologists, as well as urologists and pulmonologists responded as well.

Almost all providers agreed that biomarker testing helps them make more informed treatment recommendations, and the majority noted that more than 75% of patients who are candidates for a biomarker test get one.

However, providers also highlighted several barriers to the optimal use of these tests. Among the 15 challenges assessed, the biggest was the turnaround time to receive test results, with 71% of respondents calling this timeline a moderate barrier and 41% calling it a significant barrier. In fact, over half of respondents indicated they initiated nontargeted systemic therapies while waiting for biomarker test results.

Providers also reported a range of cost and coverage issues. For instance, two thirds of respondents cited insurance coverage for testing as moderate to significant barriers, 63% cited patient concerns about out-of-pocket costs, and 54% cited inadequate reimbursement.

Importantly, almost half of providers said prior authorization for these tests is required most, if not all, of the time. “Fortunately, a majority (57%) report that fewer than 25% of their prior authorization requests are denied,” the authors note.

Of the top things that would improve the use of biomarker tests, providers cited better tissue sampling, the ability for tests to be ordered automatically, and a reduced burden of staying up to date with biomarker testing guidelines.

“Without access to comprehensive biomarker testing, the advances in cancer care that precision medicine provides cannot be realized on a large scale,” Lacasse said. “That is why ACS CAN is committed to making sure recommended biomarker testing is covered for all cancer patients who could benefit.”

Lacasse has disclosed no relevant financial relationships.

Understanding Provider Utilization of Cancer Biomarker Testing Across Cancers. Published online December 2021. Full text

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