Alek Lee of Pike Creek is the co-leader and founder of the Delaware Youth Rare Disease Initiative.
This year, Delaware has the chance to join other states across the nation as a leader in healthcare policy. Senate Bill 120, sponsored by Sen. Spiros Mantzavinos, D-Elsmere, and Rep. Bill Bush, D-Dover, would require broad insurance coverage for medically justified biomarker testing, effective Dec. 31, if it is passed by the legislature in the coming months.
Biomarker testing describes a wide variety of laboratory panels that use a patient sample to check for specific genes, proteins or molecules that indicate the presence of a specific form of disease. By enabling early detection and tailored treatments, this testing enables precise, patient-specific care and a more cost-effective paradigm for patients and providers — parts of an improved vision for the nation’s healthcare system.
For Delawareans, biomarker tests would involve tumor-specific marker panels, cancer diagnostics and Alzheimer’s blood screening that would facilitate more timely and effective patient care. Instead of treating tumors and other illnesses based on broad characteristics, such as location and spread, doctors can prescribe treatments specific to each patient’s unique characteristics, reducing money and saving lives by avoiding costly trial and error.
With medical advances bringing an ever-growing array of testing options to the market, patient insurance has struggled to keep pace, despite strong clinical evidence demonstrating their benefits. A 2021 survey conducted by the American Cancer Society revealed that 66% of oncology providers consider insurance coverage a significant or moderate obstacle to biomarker panels for patients. Five years later, many insurance policies still do not cover these treatment-improving technologies.
Every patient and every Delawarean deserves the highest quality of medically necessary care, and gaps in biomarker coverage are simply inadequate in today’s technologically advanced landscape, more than 150 years after the discovery of the first cancer biomarker (the Bence Jones protein).
Beyond just patients, biomarker testing will play a key role in revamping the nation’s expensive healthcare system for insurers, providers and families. While these panels do pose an upfront cost, existing data suggests that they reduce the overall cost spent per patient by facilitating effective treatments in a timely manner and avoiding ineffective interventions.
Insurance for biomarker testing is a prospective, forward-thinking policy that will facilitate precision treatment and economically streamline the healthcare system of our communities. Twenty-three states have already adopted policies to expand coverage for these diagnostics, and almost a dozen introduced similar legislation this year. By passing SB 120, Delaware would not only improve medical treatment and access for its patients but join the vanguard of states leading the nation toward a more equitable, efficient and innovative healthcare system for the future.
Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.
