Sacramento, Calif. – Gov. Gavin Newsom signed the state budget on June 29, allowing for Medi-Cal implementation of Senate Bill 496. Starting July 1st, Medi-Cal and other state-regulated health insurance plans will cover comprehensive biomarker testing when supported by medical and scientific evidence.
Testing for specific biomarkers – such as gene mutations – found in blood, tissues or other biospecimens provides crucial information that can help determine the most effective treatment for a particular patient, including precision medicine and targeted therapies.
“Nearly 60% of all cancer drugs approved in the last five years require or recommend biomarker testing before use. Improving coverage for biomarker testing across insurance types is a crucial step to reduce disparities in cancer outcomes and survivorship and is increasingly important for the treatment of certain rare and autoimmune diseases, such as arthritis,” said Autumn J. Ogden-Smith, California Legislative Director for the American Cancer Society Cancer Action Network (ACS CAN).
The use of targeted treatment enabled by biomarker testing has shown an approximate 31% reduction in the risk of death for certain lung cancer patients. For César Serrano, a resident of Ontario who was diagnosed with stage-four lung cancer, access to biomarker testing was a game-changer.
“Despite being on chemotherapy, my health was taking a turn for the worse. My family and I were preparing for my imminent death when I received the biomarker testing results that led doctors to the treatment that saved my life. It was truly a miracle,” said Serrano.
While biomarker testing helps connect patients to the most effective treatment for their cancer, it can also help them save invaluable time, physical and emotional strain, and money by avoiding treatments that could prove ineffective or unnecessary. Punita Khanna, a breast cancer survivor from Los Angeles, bypassed chemotherapy thanks to her biomarker testing results indicating a low risk of recurrence.
“I had to undergo radiation and hormone therapy, which produced its own side effects, including excruciating bone and joint pain. But nothing like what I might have experienced if I had undergone chemotherapy,” said Khanna.
“This new law removes barriers to precision medicine and can potentially reduce overall health care costs by avoiding unnecessary hospitalizations and treatments. It will turn the promise of precision medicine into a reality for more Californians, regardless of race, ethnicity, sexual orientation, income or insurance type,” said Ogden-Smith.
California joins 18 other states that have enacted similar legislation. SB 496 was authored by Senator Monique Limón (D-Santa Barbara) and co-sponsored by ACS CAN and the University of California.
For more information on precision medicine, cancer biomarkers, current barriers to biomarker testing and ACS CAN’s policy recommendations, visit www.fightcancer.org/biomarkers.
