Why Timing, Access and Interpretation Matter in Oncology Biomarker Testing

Precision medicine continues to reshape cancer care, although many patients still face delays and barriers between diagnosis and treatment. In this Q&A, Abby Kim, Pharm.D., senior director of clinical strategy and oncology specialty solutions at Prime Therapeutics, shares with Managed Healthcare Executive where those gaps tend to occur most and how oncology pharmacists help close them. Kim later discusses the growing role of biomarker testing and the challenges of turning complex results into timely, accessible and affordable care.

The below conversation has been edited for length and clarity.

MHE: You’ve described oncology pharmacists as the connective tissue in precision medicine. Where do gaps usually occur between testing results and treatment today?

Kim: When I describe oncology pharmacists as the connective tissue in precision medicine, it’s because they help bridge critical gaps across the testing-to-treatment continuum. Those gaps typically arise in three main areas: the first is test ordering and interpretation. Given how quickly precision medicine is evolving, providers may not always know which biomarker test to order or how to interpret complex genomic reports. That can lead to missed opportunities.

Another area is due to turnaround and communication. Even when testing is completed, delays in reporting or unclear communication of actionable results can slow treatment decisions. If no one is actively monitoring results or following up, they can get lost. Many electronic medical records are not designed to seamlessly integrate genomic data, so results may sit in a scanned PDF or external portal, making them easy to overlook. This is where pharmacists really serve as connective tissue by tracking results, identifying actionable findings and ensuring they inform treatment decisions.

The last area is therapy access and implementation. Identifying a targetable mutation is just the first step. Ensuring access to the appropriate therapy requires coordination with payer formularies, evidence-based prior authorization policies and benefit design considerations. Pharmacists play a key role in interpreting coverage criteria, optimizing therapy selection and helping patients access affordability resources.

MHE: Many patients begin treatment before biomarker results are available. What needs to change to make sure testing happens earlier?

Kim: That’s very true, but the challenge isn’t always about testing earlier. It could be about making testing and result integration more efficient and actionable. One area is streamlined workflows. Biomarker testing should be ordered as part of the initial diagnostic process or upon progression as applicable. Embedding biomarker testing into standard pathways within the electronic medical record can help.

Another area is faster turnaround time and data integration. Electronic medical records need better interoperability so results flow directly into the clinical workflow and trigger alerts for actionable findings. There’s already a lot of solutioning happening in the market around this.

Education and awareness are also critical. Clinicians need support to understand which tests are essential upfront and why waiting for results can impact outcomes. This can be difficult for patients, who want to start treatment as quickly as possible. Oncology pharmacists help educate both providers and patients on the why behind waiting for results and reinforce these priorities.

Waiting to start therapy can change the entire trajectory of a patient’s treatment course. It can mean the difference between serious side effects that cause real harm and improved outcomes. Ensuring the right test is ordered and sent to the right lab that aligns with payer policy is also a vital part of this process.

MHE: How do oncology pharmacists help translate complex test results into treatment options patients can actually access and afford?

Kim: This is where oncology pharmacists really shine. They help bridge the gap between complex genomic reports and real-world treatment. Pharmacists interpret biomarker findings that are truly actionable and consider safety issues and drug interactions to help the care team select the most appropriate targeted therapy.

Pharmacists and their teams, including pharmacy technicians, also help make treatment feasible by navigating formularies and prior authorizations and connecting patients with financial assistance programs. Because genomic results often come through external portals, pharmacists proactively track them to make sure they are not missed.

MHE: You previously mentioned that solutions are already in progress to improve biomarker result integration. Can you share examples of what’s being developed?

Kim: Health systems and electronic medical record vendors have long recognized that integrating precision medicine data into the clinical workflow is a challenge. In the market today, you see health systems and EMR companies working to better integrate with laboratories.

The goal is not just to get results into the electronic medical record, but to embed them into the clinical workflow so pharmacists, providers or nurses are alerted when a result is back and when it is actionable, along with potential treatment options. There are a number of technologies in development, including AI-driven solutions, aimed at bringing results directly into the EMR and clinical workflow in a meaningful way.

MHE: What role do pharmacists play on molecular tumor boards that may not always be fully recognized?

Kim: I wouldn’t say health plans are necessarily overlooking the pharmacist role on molecular tumor boards. These boards have been around for over a decade and emerged as genomics became central to cancer care. They were created to bring together oncologists, pathologists, geneticists and other specialists to interpret increasingly complex molecular test results and translate them into personalized treatment plans.

That said, molecular tumor boards are still evolving as the science and volume of molecular data continue to expand. Pharmacists play a key role by evaluating how potential therapies fit into real-world practice. They help connect genomic findings to treatment options that are actionable, accessible and safe, rounding out the multidisciplinary expertise needed to make precision medicine work for patients

MHE: How can health plans better support precision medicine by aligning coverage policies with clinical guidelines?

Kim: Health plans play a powerful role in advancing precision medicine. Aligning coverage policies with clinical guidelines helps ensure consistency, predictability and high-value care. Clear policies make it easier for providers to know which tests are covered, which laboratories are in network and where specific biomarker assays should be sent.

Today’s testing landscape is complex. Different labs offer different panels, use different methodologies or require different ordering pathways. Guidance from health plans can help clinicians choose the right test and the right lab more efficiently.

When providers and payers follow guideline-recommended biomarker testing and targeted therapies are used up front when appropriate, patients and health plans can avoid low-value empiric treatments and reduce the time to the most effective therapy. That improves outcomes and ensures care aligns with evidence-based practice. Ultimately, guideline-aligned coverage supports both clinical appropriateness and cost stewardship by delivering the right therapy at the right time while avoiding downstream costs tied to avoidable toxicity, ineffective treatment or delays in initiating targeted therapy.