Texas
Convening leading members of Texas’ oncology community to discuss precision medicine and identify possible policy solutions to four key barriers improve outcomes for people with cancer.
Held in close partnership with renowned oncology leader Dr. Debra Patt of Texas Oncology as well as leaders from the Cancer Prevention and Research Institute of Texas, more than 12 attendees consisting of cancer advocacy organizations, oncologists, biotechnology officers, and academics discussed the need to support greater access to tests and screens for underserved people across the state.
PRECISION MEDICINE ROUNDTABLES
Topics
The discussion focused on barriers to precision medicine access in cancer care, emphasizing potential solutions and next steps across four key topics:
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:
- Encourage reimbursement for patient and nurse navigators
- Support health literacy tools for patients
- Streamline time-consuming paperwork required to enroll people in valuable clinical trials
- Facilitate greater education among HCPs (including PCPs) to help keep pace with rapidly evolving science
- Reduce the amount of time needed for individuals to receive access to the latest tests and treatments
- Facilitate greater education and collaboration among payors and practitioners to educate on evolving science and reimbursement needs
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:
- Ensure pathologists are working more closely with HCPs to ensure the right tests are ordered via comprehensive treatment boards
- Establish registries to collect and analyze data to identify trends in precision medicine treatment
- Give HCPs access to real-time and historical results to avoid repeat biopsies, costs and delays
- Promote greater access to labs and hospitals where testing can occur especially in rural areas and underserved urban areas
- Secure greater investment in CPRIT re: biomarker testing
- Encourage multi-disciplinary treatment planning as standard of care
Infrastructure
Barrier:
- Legacy informatics systems used by most hospitals are unable to manage the growing breadth and complexity of patient data, sometimes challenging clinicians to incorporate them into clinical practice.
Policy Solution:
- Develop information systems tools to ensure greater accuracy around test orders tied to molecular tumor boards
- Coordinate with communtiy centers (schools, libraries) to house educational resources
- Explore investments in AL to strengthen existing healthcare infrastructure
- Help develop discoverable database registry to ensure real-time access to patient data mindful of privacy restrictions
- Work to create tele-health solutions to improve access in remote areas
- Strengthen the cancer registry so that it has to drivers of precision medicine compatible with EMRs (HL7)
- Increase investments in core facilities and rural health centers and ensure access to clinical trials
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 economic value of paying for tests and › screens and clinician-recommended treatments
- Allow reimbursement for patient navigators to help realize the benefits of precision medicine
- Eliminate test redundancy by improving data collection and linking tests
- Allow for timely and streamlined prior authorization
- Ensure formulary restrictions are appropriate to allow access to new and novel therapies
- Include clinical trials as part of reimbursable standard of care
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