Precision Therapy Proves Effective, but Costly

Precision medicine, or treatments tailored to individual patients based on genetic testing and other factors, has shown incredible promise in extending the lives of some patients. The cost, however, has left many patients struggling to afford the treatments, which many insurance companies refuse to cover.

Precision medicine strategies include serial genomic sequencing to identify mutations that might be targetable by newly approved or investigational drugs. The approach has extended patients’ lives, but  unfortunately, insurance companies are hesitant to cover these “experimental” therapies. Precision therapy can cost thousands or tens of thousands of dollars each month. These costs add to the already significant financial burden of a cancer diagnosis; one study found that 42 percent of patients depleted all their assets within two years.

The Centers for Medicare and Medicaid Services announced that it will cover genetic testing for people already diagnosed with advanced cancers, a move which could cost the agency an additional $2.5 billion annually. Many insurers, however, reject demands that they cover precision medicine, arguing that the genetic sequencing technology is unproven. A spokeswoman for America’s Health Insurance Plans, an industry group, told Kaiser Health News that insurers “need a more definitive answer” on whether the tests extend the lives of patients.

Source: Kaiser Health News, November 1, 2018.