If you follow the latest cancer news and research, The Cancer Breakthroughs 2020 Program has likely caught your attention this past month. Not only did Cancer Breakthroughs 2020 officially kick off, along with its sponsoring organization the National Immunotherapy Coalition (NIC), it also reached its first clinical trial milestone. Yet another key Cancer Breakthroughs 2020 news item that you may have noticed was the January 11th announcement that Independence Blue Cross, member of the NIC, would cover next-generation whole genome sequencing for a variety of cancers. This was a bold stance for Independence Blue Cross, as the first major insurer to offer coverage for genomic proteomic sequencing (GPS). And now they have taken this stance and put it into action with this week’s release of Independence’s Medical Policy for coverage of full-genome sequencing.
Changing Medical Policy for Full Genome Sequencing Coverage
There is no doubt that the January 11th announcement was a huge step for cancer care, but one could argue that in many ways the subtle release of the medical policy is more significant. Independence, once it made the announcement, could have waited until next year to implement coverage and realistically, getting all the ducks in order to do this could have taken longer than a year. Changing medical policy and introducing new coverage within insurers is not easy. In fact, it’s not unusual for it to take up to one year to 18 months to introduce new benefits. For example, actuaries need to calculate pricing, utilization management needs to analyze membership and potential usage, experts must be brought in to help craft and review the policy, etc. Even customer service needs to be trained to respond to member and provider calls about the policy. All of this has to come together for a benefit to be introduced. In just a month, (23 days to be exact) Independence followed through and delivered the medical policy in record time. Next month its commercial members can have coverage for full-genome sequencing. This demonstrates just how committed they are to providing innovative and promising new advances in care to their members.
More Payers Should Cover Full Genome Sequencing
This is no doubt a huge step in the right direction. In our eyes, it’s also a loud call to action to other payers to offer this same benefit. By releasing the medical policy, Independence not only became the first true insurer to cover full genome sequencing, but it also laid the framework for other payers to step up for GPS, the beginning of the evolution of proteomics in the clinical world. For patients, this is good news. The reality is each one of us, including those of us at health plans, has been touched by cancer. As Daniel J. Hilferty, president and CEO, Independence Blue Cross stated,
“Decisions around cancer care are complex and personal. We’re focused on supporting Independence members and their oncologists by offering coverage for this innovative approach to treating cancer.”
With coverage for full genome sequencing, cancer care is closer to being truly personalized. Employers, healthcare providers and patients should start asking for coverage and pressure their health insurance carriers to cover full genome sequencing for cancer care. It’s time that more organizations follow the lead of Independence Blue Cross and step up.