New York

Roundtable

Convening leading members of New York’s oncology community to discuss precision medicine and identify possible policy solutions to four key barriers to improve patient outcomes.

Held at Albany’s historic Fort Orange Club and moderated by The American Cancer Society Cancer Action Network of New York, more than 14 attendees participated, including select legislators, oncologists, pathologists, researchers, patient advocates, payor representatives and science officers to discuss how best to improve access to important tests while keeping with existing state regulatory and quality care standards.

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Topics

The discussion focused on barriers to precision medicine access in cancer care, emphasizing potential solutions and next steps across four key topics:

Clinical
HCP Collaboration
Regulatory
Reimbursement

Clinical

Barrier:

  • Precision medicines are quickly being approved, challenging health professionals and patients to stay abreast of new treatments and testing requirements to improve treatment decisions.

Policy Solution:

  • Set standards for continuing medical education
  • Promote next generation sequencing, and test as much up front to identify heeditary risks
  • Improve health education quality and access for at-risk populations
  • Allocate greater resources and attention to the needs of patients in rural areas via genetic counselors and patient navigators
  • Address a general shortage of patient navigators and genetic counselors

HCP Collaboration

Barrier:

  • Key decisions regarding genetic sequencing often don’t involve the entire treatment team, which can hinder uptake of novel technologies and diminish patient outcomes.

Policy Solution:

  • Encourage the creation of diagnostic management teams to foster stronger collaboration between clinicians and pathologists
  • Implement “patient tissue navigators” to run point
  • between oncologists and pathologists test orders so they can focus more on lab work
  • Develop an electronic request system to help ensure test orders are received and properly documented
  • Centralize EMRs so clinicians across institutions have historical knowledge of patients’ history

Regulatory

Barrier:

  • Regulatory requirements often place significant burdens on physicians to receive approval to order testing for patients and protracts the timeline to availability.

Policy Solution:

  • Increase the number of government staff who review test requests to expedite approvals
  • Address a shortage of pathology lab technicians by easing regulatory burdens for obtaining licensees to practice in NY and by allowing reciprocity for experienced-technicians to practice between states
  • Continue discussions around CMS 14-day rules with a goal of streamlining comprehensive testing in NY
  • Generally ease the regulatory burden around testing approvals to streamline and expedite testing while still maintaining quality standards

Reimbursement

Barrier:

  • High standards for demonstrating clinical and economic utility can pose coverage and payment challenges for treatment informed by novel diagnostics.

Policy Solution:

  • Educate payors on the value of approving recommended › screens, tests and treatments
  • Strengthen ties between industry and payors when it comes to sharing clinical data to help substantiate reimbursement
  • Encourage payors to authorize next-generation sequencing that ultimately improves treatment outcomes
  • Enlist navigators to support clinicians and patients when it comes to issues of authorization and reimbursement

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