Pioneering Cancer Treatment Should be Available to All

By Vin Gopal

We are sponsoring legislation to ensure that insurance coverage keeps pace with an important innovation in cancer treatment.

Cancer comes in many forms and being able to match a person’s specific type of cancer with the most effective treatment can be life changing and life saving. That’s why we want to make sure insurance companies cover biomarker testing, which connects cancer patients to the right treatment at the right time. Biomarker testing often results in improved outcomes and better quality of life.

Biomarker testing is a laboratory method that uses a sample of blood, tissue, or other body fluid to look for genes, proteins, and other molecules that may indicate a disease or condition. In some cases, biomarker testing may provide information that enables patients to forgo ineffective treatments and eliminate the potentially harmful, life-altering side effects of those treatments. Not only does it save lives, it also reduces healthcare costs by eliminating costly treatments that may prove ineffective but still cause harmful, life-altering side effects.

Biomarker test results can serve as a roadmap for the best path when it comes to choosing the optimal cancer therapy for each individual patient. It provides a wealth of information to medical providers and can help doctors connect cancer patients to the right treatment at the right time.

Despite the proven benefits, many insurers in New Jersey do not cover the most appropriate biomarker testing. This results in some patients being forced to decide whether to pay out-of-pocket or go without the testing and hope the first treatment prescribed is the right one.

In cancer, time to diagnose is critical to starting effective treatment. That’s why our bill calls for insurance companies to review and give a decision on a prior authorization request within 72 hours for a non-urgent request or 24 hours when the request is urgent.

My LD11 legislative partners Assemblywoman Margie Donlon and Assemblywoman Luann Peterpaul are strong supporters of making healthcare more accessible to all residents. Assemblywoman Donlon, who is a physician, is a cosponsor of the companion biomarker testing bill in the Assembly.

Our legislation would require that all state-regulated insurance companies, including Medicaid, cover biomarker testing for patients when it is supported by medical and scientific evidence. Seventeen other states, including New York, have passed similar legislation and we join the American Cancer Society in calling on our colleagues in the NJ Senate and Assembly to lend their voices and their votes to this important legislation.

Not all communities are benefiting from this pioneering approach driving progress in cancer treatment, with disparities in access persisting along racial and ethnic, socioeconomic, and geographic lines. New Jerseyans deserve broad and equitable access to the best treatments that 21st century precision cancer medicine can offer.

It’s time to end these disparities and to ensure that every New Jersey resident has access to this life-saving treatment.