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Committee hears case for broader insurance coverage of biomarker cancer tests
Summary
Dr. Hol told the Senate Health & Welfare Committee that biomarker testing — including circulating tumor DNA — is integral to personalized cancer care, can reduce costs by stopping unnecessary chemotherapy, and needs broader insurance coverage to be effective.
During the March 26 meeting of the Senate Health & Welfare Committee, Dr. Hol, director of the Vermont Cancer Center, urged broader insurer coverage for biomarker tests that guide targeted cancer therapies and can detect residual disease.
Dr. Hol said biomarker testing is routine in modern cancer care and provided examples: certain pancreatic cancers have BRCA mutations (she estimated about 10–15% in pancreatic cancer) that make targeted drugs effective. "We cannot use those drugs unless we do the genetic testing to make sure that we understand who's going to benefit from that kind of treatment," she said.
She also described circulating tumor DNA (ctDNA) testing, which detects tumor DNA in the bloodstream after treatment. If ctDNA becomes undetectable, clinicians may be able to stop chemotherapy earlier, reducing toxicity and long‑term costs. "We have sensitive techniques where we can actually find that DNA circulating... if that circulating DNA goes down to zero or undetectable, we may be able to stop treatment," Dr. Hol said.
Committee members pressed on cost and coverage. Dr. Hol acknowledged that biomarker and ctDNA tests can be expensive and that insurers sometimes push back, particularly for rare mutations or indications with limited literature. She argued that the long‑term savings from avoided months of chemotherapy and better‑targeted care could outweigh upfront testing costs.
The exchange highlighted a policy gap the committee might monitor: broader coverage standards or legislation to ensure access to clinically indicated biomarker testing, especially as tests like ctDNA move from niche to broader clinical use.
