California just took a significant step toward equitable access to personalized medicine, which is becoming the standard of care for people with cancer. Last week, Governor Newsom signed Senate Bill 496: Biomarker Testing into law. Authored by California State Senator (and UC Berkeley alumna) Monique Limón, the new law will require Medi-Cal and private insurers to cover medically necessary biomarker testing – allowing more people to access effective, individualized cancer treatments. The bill was co-sponsored by American Cancer Society Cancer Action Network and the University of California, with expert insight from the University of California Cancer Consortium.
“Biomarker testing is a key cornerstone of modern cancer diagnostics and patient care and has a pivotal role in improving health care outcomes. As an academic pathologist, I understand the guidance biomarkers offer to physicians for choosing the most appropriate therapies and the role biomarkers have in helping predict patients' responses to treatment. Health care providers will now be in a better position to tailor treatments for each patient, ultimately enhancing patients' overall quality of life," commented Michael Teitell, MD, PhD, director, UCLA Jonsson Comprehensive Cancer Center and current chair of the UC Cancer Consortium.
"With SB 496 now signed into California law, this will help enable widespread availability and equitable access of biomarker testing for individuals residing in our state. This legislation holds the promise of profoundly benefiting patient’s lives and advancing health care throughout California,” Dr. Teitell said.
Care for many types of cancers, as well as other diseases, is now driven by personalized, or “precision”, medicine. Precision medicine adapts treatment protocols to the specific molecular characteristics of a tumor, which can vary greatly from case to case. This individualized approach allows health care providers to predict and match the best treatment for a specific condition for an individual patient. Biomarker testing is a critical component of precision medicine because it gives health care providers molecular information from a patient’s blood, tissue or other biospecimens to help in diagnosing and understanding the underlying biology of a cancer to inform treatment options. Health care providers use the information from biomarker testing for screening, diagnosis, treatment, targeted therapy and monitoring the disease status.
“Biomarker testing can help health care providers render the right treatment at the right time and is increasingly important for cancer care and the treatment of diseases like arthritis and other autoimmune and rare diseases. With research happening in other areas, biomarkers may be available in the future to treat Alzheimer’s, neurological conditions, and more,” added State Senator Monique Limón (D-Santa Barbara), the author of the legislation. “This bill removes barriers to precision medicine and can potentially reduce overall health care costs by avoiding unnecessary hospitalizations and treatments.”
Precision medicine, and especially biomarker testing, has revolutionized cancer treatment. In the last five years, 60 percent of approved cancer treatments required or recommended biomarker testing before use. However, not all communities are benefitting from the latest advancements in biomarker testing. Sixty-six percent of oncology providers in a recent survey reported insurance coverage for biomarker testing remains a significant or moderate barrier to appropriate biomarker testing. For example, Medicaid enrollees diagnosed with advanced, non-small cell lung cancer were 19 percent less likely to receive biomarker testing than comparable patients with commercial insurance, and 30 percent less likely to receive a targeted treatment.
“Knowing the biology of cancer is essential to identifying the most effective treatments. Biomarkers can help doctors better see what makes certain cancers tick, allowing for a more personalized approach to diagnosing and treating the disease. This is the essence of precision medicine, which customizes treatment based on the molecular makeup of the cancer," said Primo “Lucky” Lara, Jr., M.D., director, UC Davis Comprehensive Cancer Center and current co-chair of the UC Cancer Consortium.
"Everyone should have equitable access to these life-saving tests regardless of their insurance provider. That’s why SB 496 is a win for all Californians with cancer,” Dr. Lara shared.
Under the new law established by SB 496, cost will no longer be as big a barrier to biomarker testing for patients in California. Now, people covered by Medi-Cal and private insurers will be able to take advantage of the newest advances in genomics and precision medicine to gain equitable access to effective, life-changing treatments.