Breast Cancer Genomic Testing Economics

Jordan Clark

Jordan Clark of Diaceutics comments on the American Journal of Managed Care article ‘Economics of Genomic Testing for Women With Breast Cancer’ and highlights that personalized medicine is being held back by the unwillingness of payers to reimburse genomic testing.

Robert D Lieberthal, PhD, from the Jefferson Population Health Continuing Professional Education Collaborative, describes in the American Journal of Managed Care (http://www.ajmc.com/publications/issue/2013/2013-1-vol19-n12/economics-of-genomic-testing-for-women-with-breast-cancer/4) what he believes to be the first structured review of the economics of breast cancer care.  The NIH estimates that the annual financial burden of breast cancer is around $14 billion. Lieberthal’s excellent review highlights what is generally agreed, namely that genomic testing and personalized medicine can reduce costs but that there is still inadequate reimbursement for genomic studies.

We wholeheartedly agree with the recommendation from Dr Lieberthal that more studies into the health economics of personalized medicine are urgently needed. In addition, the move towards inclusion of direct clinical trial data as the backbone of such studies would be an improvement on the current modeling algorithm approach. He eloquently visualizes the direct and indirect cost of breast cancer care and it is a stark reminder that genomic testing is only a small, but essential, gear in the patient care pathway.

Elsewhere in the Expert Insight titled “Why PM1.0 Will Not Create Radical Health Care Change Prompting the Need for PM2.0” we discuss that in order for personalized medicine to fulfil its potential, we must start taking the long-term holistic view of health economics, rather than a short-term detrimental view, that will not fund genomic testing in the order of $100s. The cost of genomic testing pales into insignificance when compared to the potential direct and indirect cost savings of treating cancer using precision medicine.

Of course, we recognize that the fragmentation of stakeholders and inefficiencies of reimbursement systems currently supporting personalized medicine, and companion diagnostics in particular, are holding back a shift to PM2.0. However, it all starts with the data and this paper should ring alarm bells for us all given that even in breast cancer, where we now have some of the most advanced biomarker and risk assessment tools, we do not have the business model sorted out. Pity.


View all blogs

Webinars & Podcasts

Podcast: How Diaceutics is repairing the diagnostic testing ecoystem for patients worldwide
Diaceutics CEO, Peter Keeling joins Pat Kenny on Newstalk FM to discuss how analyzing Big Data to implement better diagnostic testing can help patients access better treatment options for cancer and other life-threatening diseases....
Liquid Biopsy in NSCLC
View all

Expert Insights

The CMS National Coverage Decision on NGS
I. Introduction On March 16, 2018, the Centers for Medicare and Medicaid Services (CMS) finalized a National Coverage Determination (NCD) that...
EU IVD Regulation – What does it mean for companion diagnostics and LDTs?
Dave Smart, PhD, Director at Diaceutics, discusses the introduction of the EU IVD Regulation. While it is considered a necessary step, the...
View all expert insights

Competitive Benchmarking Reports

Pharma Precision Medicine Readiness Report 2019
PM Readiness Report 2018 Summary
View all reports


TRK fusion positive cancers: From first clinical data of a TRK inhibitor to future directions
Genetic alterations of neurotrophic tropomyosin or tyrosine receptor kinase (NTRK) 1/2/3 genes generate TRK fusion proteins have been reported in a variety of adult and child cancers from diverse cell/tissue lineages. Larotrectinib, a...
Challenges in the clinical implementation of precision medicine companion diagnostics
The pace of biomarker discovery has increased exponentially over the last few years,ushering in an era of precision medicine (PM) with a growing arsenal of treatments tailored to specific patient populations....
View all publications