Kentucky Biomarker Bill: The Right Test for the Right Treatment

Author: Dr. JP Canner, Ph.D., NRCC, MT(AAB)

The right test for the right treatment. 

The Commonwealth of Kentucky enacted HB180 this year which mandates insurance coverage of biomarker testing.  Kentucky joins 13 other states with legislation addressing this complex issue.

Biomarkers can either be direct targets or closely associated indicators of a disease.  An example of the latter is Hemoglobin A1C for diabetes, as this marker is tightly associated with the disease, but not the driver of diabetes.  Regarding direct targets, determining which biomarkers are present is the key to precision medicine.  This is found extensively with cancer treatments and these legislative actions are championed by those impacted by this disease. 

Cancer covers a broad range of diseases depending on the type of cancer, but also on the molecular mechanisms driving the disease.  A clear example of the complexity of biomarker testing is determining appropriate treatment options for Non-Small Cell Lung Cancer (NSCLC).  According to the National Comprehensive Cancer Network Guideline for NSCLC, advanced or metastatic diseases should be tested for genetic mutations in EGFR, KRAS, ALK, ROS1, BRAF, NTRK1/2/3, MET, RET, and ERBB2(1).  Then, guided therapeutic options would be chosen based upon the detection of any oncogenic variants found within the cancerous cells.  As you have probably guessed, finding the proverbial needle in the haystack is a costly endeavor.   Therefore, ensuring that an individual’s insurance company provides coverage for these tests is an important barrier to remove for treatment. 

Kentucky’s HB180 goes a step farther than others, and specifically cites the need to cover pharmacogenetic (PGx) testing.  PGx analyzes a subset of genes that are involved in either metabolism, transport, or are a direct target of a medication.  Based on the findings of the genetic analyses, certain medications may or may not be the best option for that individual.  By including this important testing in HB180, Kentucky is ensuring its residents will have access to current testing procedures, but also future biomarker analyses that will improve outcomes. 

Gravity offers a variety of testing options, including PGx testing, and we’re looking forward to continuing our efforts to improve healthcare for all. 

(1) National Comprehensive Cancer Network Guideline: Non-Small Cell Lung Cancer. Version 2.204