Friday, August 7, 2020

Personalized Medicine Coalition: Inconsistent Use of Genomic Testing

On August 7, 2020, the Personalized Medicine Coalition, Illumina, BCBS Association, and Concert Genetics released a new report that "compares real world health insurance claims for genomic testing" with coverage policies.

The report finds "wide variation and a lack of clarity in payer coverage."   

  • See the press release here.   
  • See the 28 page PDF report here.  
  • For brief coverage at Genomeweb, here.

The report's take home lessons are:

  1. Medically appropriate genomic testing is inconsistently utilized.
  2. Payer genomic policy vary considerably.
  3. Favorable coverage may not correlate with increased utilization.
  4. Inconsistent policies are barriers, but policies alone don't explain inconsistent access.


For some recent academic publications on similar topics, see:

  • AMP Committee: Sireci et al, 2020, Molecular Pathology Economics 101 here.
  • UCSF: Douglas et al., 2020, Coverage of ctDNA testing, here.
  • UCSF: Trosman et al, 2020, Tumor sequencing coverage 2015-2019, here.
  • UCSF: Deverka et al., 2020, Payers and NGS tests, here.