Sacramento, Calif. – The California Legislature passed a bill Thursday night to ensure that more health insurance plans, including Medi-Cal, cover comprehensive biomarker testing when supported by medical and scientific evidence. Senate Bill 496, sponsored by the American Cancer Society Cancer Action Network (ACS CAN) and the University of California, has received strong, bipartisan support throughout the legislative process. It now heads to the governor’s desk.
“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.”
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. For example, patients with certain lung cancer types who received biomarker testing and targeted therapy saw a 31% reduction in risk of death.
“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.”
Biomarker testing could also help patients save invaluable time and prevent physical, emotional and financial strain by avoiding treatments that are likely to be ineffective or unnecessary and their potential life-altering side effects.
“I was able to bypass chemotherapy thanks to my biomarker testing results indicating that the recurrence of my cancer was low. 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 Punita Khanna, who was diagnosed with breast cancer seven years ago.
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. Additionally, nearly 60% of all cancer drugs approved in the last five years require or recommend biomarker testing before use.
Despite the proven benefits, insurance coverage for biomarker testing is failing to keep pace with innovations and advancements in treatment, resulting in some patients being forced to pay out-of-pocket, incur debt or go without this game-changing testing.
“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 is fundamental to reducing health disparities as precision medicine grows. We thank the Legislature for passing the bill and urge Governor Newsom to seize this opportunity to help turn the promise of precision medicine into a reality for more Californians.”
A dozen states nationwide have enacted legislation expanding access to biomarker testing, including our neighboring state of Arizona.
