Lack of reimbursement for comprehensive genomic profiling tests continues to be one of the major barriers impeding patient access to potentially life-extending therapies for which the patient is a molecular match.
—Bonnie J. Addario
Foundation Medicine, Inc. recently announced that it has signed a national agreement for the company’s comprehensive genomic profiling assay for solid tumors, called FoundationOne, with UnitedHealthcare. The agreement, which became effective December 15, 2015, covers the assay for patients with stage IV non-small cell lung cancer (NSCLC).
The assay is a comprehensive genomic profile that enables physicians to make treatment decisions for patients with cancer by identifying the molecular growth drivers of their cancers and by helping oncologists match the identified drivers with relevant targeted therapeutic options. Requiring only a small amount of tumor tissue, the assay interrogates the entire coding sequence of 315 cancer-related genes plus select introns from 28 genes that are known to be altered in solid tumors.
“UnitedHealthcare’s coverage decision is a critical first step towards ensuring that comprehensive genomic profiling becomes standard-of-care treatment for patients with metastatic disease,” said Bonnie J. Addario, lung cancer survivor, and Founder of the Bonnie J. Addario Lung Cancer Foundation and the Addario Lung Cancer Medical Institute. “Lack of reimbursement for comprehensive genomic profiling tests continues to be one of the major barriers impeding patient access to potentially life-extending therapies for which the patient is a molecular match.”
“This national coverage agreement with UnitedHealthcare is an important step towards broader reimbursement for Foundation Medicine, and importantly, it’s a significant advance for patients with metastatic NSCLC,” said Michael Pellini, MD, Chief Executive Officer for Foundation Medicine. “Studies demonstrate that improved clinical outcomes are achieved by matching patients to targeted therapies based on the unique genomic alterations contributing to the disease. We look forward to building upon our relationship with UnitedHealthcare and other national insurers as we continue to demonstrate clinical and economic evidence supporting coverage and payment for FoundationOne in additional cancer types.” ■