The biomedical research ecosystem has delivered advancements that not long ago would have been inconceivable, exemplified by highly effective COVID-19 vaccines developed by global partners and approved in less than a year. The United States stands at a moment of unprecedented scientific promise and is challenged to ask: What more can we do to accelerate the pace of breakthroughs to transform medicine and health?
Biomedical breakthroughs for cancer have enhanced research and discovery at record rates, giving patients extraordinary survivorship opportunities. It is a remarkable, unprecedented time. At the vanguard of understanding is the role of biomarkers and identifying each patient’s unique cancer signature through biomarker testing. Through the testing process, patients and providers can better determine an appropriate, individualized treatment path.
Increasing Access Means Paying for Testing
“Without action to expand coverage of and access to biomarker testing, advancements in precision medicine could increase existing disparities in cancer outcomes by race, ethnicity, income, and geography,” the American Cancer Society Cancer Action Network (ACSCAN) said.
For the past 24 months, ACSCAN led a concerted advocacy campaign in multiple states to introduce and pass legislation for biomarker testing coverage legislation. ONS added the nurse’s perspective during those lobbying initiatives, increasing the endeavor’s credibility with their trusted voices. If passed, the state legislation would improve access for many underserved populations, enabling them to engage the power of precision medicine to achieve their optimal cancer outcomes.
As public policy and evidence-based practice find a nexus, advocates are seeing a place for increased insurance coverage for preventive services. Seven states have already passed legislation mandating biomarker testing coverage. Most recently, orchestrated bipartisan legislation passed the Kentucky and Georgia state chambers and were enthusiastically signed into law by their respective governors. Additionally, 14 other states are considering similar bills in 2023.
Nurses Join Coalition to Support State Laws
As specialty nurses in the most trusted and ethical profession, ONS members have used their cache of goodwill in multiple state coalition efforts to highlight the critical need for legislation and promote patient-centered care. Biomarker testing coverage is enjoying a wave of support among members of both parties who are eager to pass remedies that focus on the patient, provide real information for decision-making, and lower long-term healthcare costs.
State Representative Kim Moser (R-KY) is a nurse and serves a rural community in northern Kentucky. In February 2023, Moser introduced biomarker testing coverage legislation, explaining that “nearly 60% of all cancer drugs approved in the last five years require or recommend biomarker testing,” and “currently, Kentucky is in the bottom 10 states for biomarker testing coverage. This bill will change that by greatly expanding biomarker testing coverage so more patients can use this lifesaving tool. Biomarker testing is an essential step toward improving cancer outcomes.”
Her bill passed the Kentucky House and the Senate without any opposition. Moser credits her nursing background as part of her leadership in shepherding dynamic legislation through the state house and to the governor’s desk for enactment.
In early April 2023, New Mexico’s bill requiring “group health coverage, including self-insurance, offered, issued, amended, delivered, or renewed under the Health Care Purchasing Act shall provide coverage for insureds to receive biomarker testing” was signed into law. In early May 2023, Georgia passed a bill that requires “health benefit policy coverage for biomarker testing if supported by medical and scientific evidence.” Maine, New York, and Ohio have introduced parallel legislation, and ONS is formally involved with the ACSCAN coalition pushing for passage.
As more states rack up wins for biomarker testing legislation, regional passage will become a national trend. This is a rare, united program area that has a direct impact on patient care. Nurses have added much to that success, helping decision-makers understand the necessity of using evidence to drive policy.