Lawmakers joined hundreds of cancer survivors in Albany on Tuesday in support of legislation to require health insurance providers cover biomarker testing for patients, but insurance companies aren't on board.
Tuesday's Cancer Action Day at the Capitol was centered on a new bill to mandate all health insurance policies that provide major medical coverage and Medicaid to cover biomarker testing for diagnosis, treatment or to manage a person's disease.
"We're talking about the future of cancer care," said Michael Davoli, American Cancer Society Cancer Action Network's senior government relations director. "What science has showed us is precision medicine is the future, but to unlock precision medicine, we need to improve access to biomarker testing."
Biomarkers measure a person's biological processes, pathogens and responses to a certain treatment, and also identify genetic mutations that could influence the most effective treatment. Every person diagnosed with cancer has a disease unique to them, meaning they would not benefit from all treatments.
Advocates with the American Cancer Society say it'll ensure cancer patients in New York have access to precision medicine, or have access to the best treatment available.
"Unfortunately, there are millions of New Yorkers who don't have access to biomarker testing because their health insurance plans don't cover it," Davoli said.
It's a treatment that would have changed Denise Romand's life. The Saratoga Springs resident, originally from Colonie in Albany County, fought and survived Hodgkin's lymphoma 30 years ago with high doses of chemotherapy and radiation followed by bone marrow and stem cell transplants.
"You might not have to go through a huge, long course of chemo or radiation," she said Tuesday. "You might be able to have this very pinpointed treatment that specifically works on your cancer."
Advocates argue the testing would eliminate excessive testing and treatment, saving companies money in the long run.
Eric Linzer, president and CEO with the state Health Practitioner Association, says the bill sets overly broad criteria to require biomarker tests, which may not align with the best medical practices.
The legislation would require federally approved biomarker tests to be covered, but Linzer says federal approval indicates safety of a medical treatment and not when it should be used.
"While certain tests may offer promising tools, in some instances, there's inconsistency in the published results," Linzer explained. "And there's insufficient evidence in some instances in the peer-reviewed literature."
Linzer also pushed back on the argument mandating coverage of biomarker testing would be most cost-effective for insurance companies. Targeted therapies help patients get treatment faster and cut down on costs, but insurance providers continue to have concerns about the legislation's broad scope and criteria.
"Setting a relatively broad set of criteria, when the science and literature really, in some instances may need to catch up... The focus should be on making sure that what we're covering is based on sound medical evidence and guidelines based on clinical evidence [and] peer-reviewed literature," he added.
Health practitioners and insurance providers are eager to negotiate the proposal with lawmakers, but Linzer says they have yet to be invited to participate in the discussion.
Bill sponsor Sen. Roxanne Persaud says she's prepared for the pushback from health insurance companies to make changes to help save lives.
"Insurance companies will push back on everything that you ask them for except raising insurance rates — they wouldn't push back on that," said Persaud, a Brooklyn Democrat. "But we have to ask them, where's the humanity in it when you know you can help assist somebody, prevent something to causing someone's premature death?"
Other lawmakers, including Sen. James Skoufis, attended Tuesday's event in the Legislative Office Building, saying they intend to sign on to co-sponsor the legislation and get it over the finish line this session after the state budget is completed.
The last scheduled day of session is June 8.