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PGx Biomarker Testing: Covered Soon for All Californians

By March 7, 2024No Comments

Good news for CA providers and residents!

Starting July 1, 2024, Pharmacogenomic (PGx) biomarker testing will be a covered benefit for all Californians*, regardless of insurance provider. PGx testing is already a covered benefit for Medicare patients.

Read the press release below, and learn more on the American Cancer Society’s Cancer Action Network website.

Read the legislation here.

*For insured Californians meeting testing criteria mandated by California Senate Bill 496.

 


 

Governor Newsom Signs Game-Changing Legislation Aimed at Improving Health Outcomes, Quality of Life for Californians

 

CANCER ADVOCATES APPLAUD GOV. NEWSOM FOR SIGNING THE BIPARTISAN BILL TO ENSURE MORE PATIENTS CAN ACCESS BIOMARKER TESTING THAT CAN CONNECT THEM TO THE RIGHT TREATMENT AT THE RIGHT TIME

 

October 7, 2023

 

SACRAMENTO, Calif. – California Governor Gavin Newsom announced he has signed Senate Bill 496 on Saturday, ensuring that more health insurance plans, including Medi-Cal, cover comprehensive biomarker testing when supported by medical and scientific evidence. The bill, sponsored by the American Cancer Society Cancer Action Network (ACS CAN) and the University of California, received strong, bipartisan support throughout the legislative process.

“We thank the Legislature and Governor Newsom for taking this crucial step to turn the promise of precision medicine into a reality for more Californians. A longstanding leader in health equity and medical innovation, California joins twelve other states that have enacted similar legislation,” said Dr. Karen E. Knudsen, CEO of ACS CAN. “This action ensures California continues to pave the way for the fight against cancer and other chronic diseases and will improve access to the most effective treatments – including those in clinical trials – giving patients a better chance of living longer, healthier lives.”

“People of color, individuals with limited income, and rural residents are less likely to receive biomarker testing,” said Autumn J. Ogden-Smith, California Legislative Director for ACS CAN. “Improving coverage for biomarker testing across insurance types prevents patients from being forced to pay out-of-pocket, incur debt, or go without this game-changing testing, and is fundamental to reducing health disparities as precision medicine grows.”

Testing for specific biomarkers – such as gene mutations – found in blood, tissues or other biospecimens – is the key to unlocking precision medicine, including targeted therapies, that often improve survivorship and quality of life for cancer patients and others with chronic diseases.

“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,” said 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.”

Punita Khanna, a breast cancer survivor, bypassed chemotherapy thanks to her biomarker testing results indicating a low risk of recurrence.

“I had to undergo radiation and hormone therapy, which produced its own side effects – such as excruciating bone and joint pain – but nothing like what I might have experienced if I had to undergo chemotherapy,” said Khanna.

Clinical trials fuel medical innovation and the development of new cancer treatments and are increasingly driven by biomarker testing, which facilitates participation by helping identify eligible patients. Nearly 60% of all cancer drugs approved in the last five years require or recommend biomarker testing before use.

“In July 2021, I was diagnosed with stage-four lung cancer after developing symptoms that I thought were from COVID. Within weeks, I could barely stand and would go unconscious and wake up in an ambulance. I went on chemotherapy, and it was doing more damage. My family and I were preparing for my imminent death,” said César Serrano. “Then, I received the biomarker testing results that led doctors to the treatment that saved my life. It was truly a miracle.”

For more information on precision medicine, cancer biomarkers, current barriers to biomarker testing and ACS CAN’s policy recommendations, visit www.fightcancer.org/biomarkers.

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