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A movement to make cancer treatment more personalized, more targeted and more effective has real potential for patients – but only if they can access the needed diagnostics and medications. As a new video and policy brief from the Alliance for Patient Access explain, regulatory and health plan models must evolve if cancer patients are to realize the promise of precision medicine.

“Improving Cancer Patients’ Access to Precision Medicine”

In “Improving Cancer Patients’ Access to Precision Medicine,” oncologist Alan Marks, MD, and clinical researcher Sloka Iyengar examine how genomic sequencing of tumor tissue can help physicians determine the Screen Shot 2016-05-30 at 11.05.59 AMbest course of treatment for patients. Despite conventional mindset, a tumor’s genetic make-up may be a better indicator than its location in the body as to what treatment is most likely to succeed.

Several barriers impede access to precision diagnostics, however. Time-strapped physicians struggle to stay current on the intricacies of precision medicine and have no practical guidelines to consult for key questions, such as when patients should be tested and whether testing should also include high-risk family members. Meanwhile, the paper explains, regulatory bodies struggles to provide adequate oversight and to adjust clinical trial procedures to meet the needs of precision medicine.

Health plans are also slow to accommodate emerging oncology treatment approaches. Insurance coverage sometimes requires proof of precision diagnostics’ “medical necessity,” which is difficult to demonstrate for emerging technologies. Precision and immuno-oncology therapies that are already on the market, the papers’ authors note, often require exorbitant cost-sharing.

“Access to Immuno-Oncology Therapies”

AfPA’s new video, “Access to Immuno-Oncology Therapies” takes the conversation on health plan cost sharing a step further. By requiring patients to pay 20-25 percent of the cost of new immuno-oncology therapies, the video explains, health plans are deterring cancer patients from accessing the very therapies that could save their lives.

Immuno-oncology therapies vary from traditional chemotherapy by harnessing the power of the body’s immune system in fighting off cancer cells.   The breakthrough drugs are credited with helping former President Jimmy Carter fight off melanoma at age 91.

To learn more, read “Improving Cancer Patients’ Access to Precision Medicine” and watch “Access to Immuno-Oncology Therapies.”

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