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Wide Variation in Genomic Testing Utilization Across US, Report Finds

NEW YORK – Genomic testing is inconsistently utilized in the US, even among states that have favorable coverage policies, according to a report from the Personalized Medicine Coalition released on Friday. 

Conducted in partnership with the Blue Cross Blue Shield Association, Concert Genetics, and Illumina, the report said that though wide variation and a lack of clarity in payer coverage policies may present hurdles to genomic testing, other factors may also be preventing greater adoption of such testing.

The collaborators examined three types of genomic testing: Noninvasive prenatal testing, whole-exome sequencing in patients with rare and undiagnosed genetic diseases, and comprehensive genomic profiling of tumors in patients with advanced cancer. They provided four key conclusions – medically appropriate genomic testing is inconsistently used across US states; payer coverage for genomic testing varies "considerably" among states; favorable coverage policies do not always result in higher utilization rates across states; and inconsistent coverage and reimbursement policies are barriers to genomic testing access, but do not fully explain inconsistent utilization.

The report also identified opportunities to improve genomic testing adoption, including the continued development and dissemination of evidence supporting the clinical and economic utilization of testing. It also said that a better understanding of the clinical and economic benefits of genomic testing is needed. "This includes addressing socioeconomic determinants of health, as well as increasing genomics awareness and education for stakeholders across the health system," the report said.

The report "reminds us that we need to address a wide range of clinical adoption issues in order to facilitate more widespread utilization of the tests and treatments underpinning personalized medicine, which benefits patients and health systems by targeting treatments to those who will benefit," Personalized Medicine Coalition President Edward Abrahams said in a statement.