Independence Blue Cross president: Why we cover whole genome sequencing

October 31, 2016

After carefully considering its promise and consulting with experts, Independence Blue Cross this year became the first major insurer to provide coverage for certain members who are seeking access to whole genome sequencing.

HilfertyWhen it comes to covering emerging medical technologies, insurers must responsibly steward the resources of those who ultimately pay for healthcare-employers, governments, and individuals who buy health insurance. At the same time, we must embrace our role in giving patients access to life-saving innovations as quickly as possible. Nowhere is that balance more important than cancer care.

Personalized medicine is revolutionizing clinical care, including oncology, and the next great leap forward in cancer treatment may be just around the corner. New genetic tests can show which treatment regimen will be most effective in an individual, and what therapies are unlikely to work and may even cause more suffering. Among the most promising advances is whole genome sequencing, which fully sequences thousands of genes in a single test. Whole genome sequencing detects specific DNA mutations that may guide oncologists to the optimal treatment for each of their patients.

Doing what’s best for patients

After carefully considering its promise and consulting with experts, Independence Blue Cross this year became the first major insurer to provide coverage for certain members who are seeking access to whole genome sequencing. We are beginning with patients with specific cancers for which the test is most likely to help determine effective therapies: certain rare cancers, tumors in children, metastatic cancer of unknown primary, triple negative breast cancer, primary brain cancer, virally infected tumors, and metastatic cancer where conventional therapies have been exhausted and patients remain candidates for further therapy.

Whole genome sequencing for cancer is an evolving area of medicine that requires ongoing research and evaluation. Our decision to make this test available for the patients who might benefit the most reflects our commitment to our members to balance innovation and cost management.

Collective effort needed

The success of personalized medicine also depends on vastly expanding the evidence base across all types of cancer and all clinical circumstances. To that end, Independence supports the Cancer MoonShot 2020 Program, which you’ll read about in this issue on page X. The program is a series of phase 2 trials in 20,000 patients and 20 tumor types seeking quantum advances in individualized cancer treatment by 2020. I believe insurers have a responsibility to engage with efforts like this that are bringing stakeholders together to find new solutions.

Independence is proud to promote both of these objectives-testing a patient’s entire genome to find out how best to treat her or his individual cancer, and accelerating the large-scale research that will lead to new therapies. We know these are ambitious undertakings, but given the toll that cancer takes on our community, ambitious thinking is exactly what is needed.

Daniel J. Hilferty is president and CEO of Independence Blue Cross.