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"Evolving Conversations with US Payers About Comprehensive Genomic Profiling"

Comprehensive Genomic Profiling (CGP) is a method of cancer diagnosis and prognosis that uses genomic information to determine treatment plans. CGP is an important tool in cancer care, given that cancer is the second leading cause of death in the US and is understood to be a disease of the genome.

Assessing the clinical utility of CGP is complex given the increasing number of genomic markers it identifies, resulting in challenges for US healthcare payers who have to navigate these complexities in their coverage policies.

Evaluating CGP on a gene-by-gene basis is not sustainable, and coverage policies are gradually shifting to consider CGP as a holistic process, despite the challenges posed by the expanding number of genes included and a dynamic evidence base. There is also a need for alternative evidence models to demonstrate the value of CGP, including real-world data and value-based models of evidence. This may foster better collaboration between payors, health systems, biopharma, patient advocates, and other stakeholders throughout the healthcare system.

This white paper explores the evolving dialogue around CGP between payers, health systems, biopharma, patient advocates, and other stakeholders, including the complexities of assessing the clinical utility of large cancer panels and new models to demonstrate the value of comprehensive testing.

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