Payor Policy Study Reveals Progress, Challenges in Liquid Biopsy Reimbursement

Reporting their findings in the Journal of the National Comprehensive Cancer Network, investigators from the University of California, San Francisco and City of Hope analyzed about four years of data on both public and private payor coverage of circulating tumor DNA tests in what they believe is the first study of its kind.

The group used a resource called the Canary Insights Database, a public library of more than 40,000 medical policies from commercial and public payers, to track private policies, Medicare National Coverage Determinations (NCDs) and Medicare Administrative Contractor Local Coverage Determinations (LCDs) from 2015 through July 1, 2019.

Based on the patterns they identified, the team concluded that both public and private coverage of liquid biopsy tests appears to have grown significantly in recent years, though some notable limitations remain, including policies that restrict testing to specific genes or endorse only certain branded test technologies.

Source: https://www.genomeweb.com/cancer/payor-policy-study-reveals-progress-challenges-liquid-biopsy-reimbursement