First insurer covers whole genome sequencing for cancer

Independence Blue Cross has entered into an agreement with NantHealth to cover next-generation whole genome sequencing for a variety of cancers. Independence is the first insurer to cover whole genome sequencing, which fully sequences thousands of genes in a single test, detecting DNA mutations that may serve as markers that inform decisions about optimal cancer therapy.

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In addition, Independence has joined the National Immunotherapy Coalition-the nation’s most comprehensive cancer collaborative initiative, focused on accelerating the potential of combination immunotherapy as the next-generation standard of care in cancer patients. The coalition and its members will design, initiate and complete the Cancer Moon Shot 2020 Program, a series of randomized phase 2 trials in 20,000 patients at all stages of disease in 20 tumor types within the next 24 to 36 months.

Hilferty

“The science around genomics and immunotherapy and their potential to advance cancer care is evolving,” says Managed Heathcare Executive Editorial Advisor Daniel J. Hilferty, president and CEO, Independence Blue Cross. “Entering into a relationship with NantHealth, and supporting the Cancer Moon Shot 2020 Program, are two ways that we are responsibly contributing to the evidence-base and-potentially-helping to advance cancer care.”

Independence’s agreement with NantHealth involves a very specific and complex lab study related to cancer, next-generation whole genomic sequencing of tumor DNA, and related proteomic testing, for certain types of cancer, according to Hilferty.

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The test will be covered for members with specific conditions including rare cancers, tumors in children, metastatic cancer of unknown primary, primary brain cancer, triple negative breast cancer, and metastatic cancer where conventional therapies have been exhausted and patients remain candidates for further therapy.

“This is an evolving area of science, technology and medicine,” Hilferty says. “While the evidence is far from certain for any of these tests, we looked at the space and looked at the science, and strongly believe that it makes sense to cover the most comprehensive test in the marketplace. It’s also important to note that the NantHealth test includes testing for all of the mutations for which other tests are offered.

“Decisions around cancer care are complex and personal,” Hilferty adds. “We’re focused on supporting our members and their oncologists by offering coverage for this innovative approach to treating cancer. Whole genome sequencing is one more option to help inform a personalized, effective treatment plan.”

Independence’s detailed coverage policy for clinical trials can be found at www.ibx.com

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