Testing that can help with the early detection and treatment of diseases including cancer, Alzheimer’s and multiple sclerosis will be accessible to more patients soon.
Right now, health insurance companies don’t have to cover biomarker testing in New Jersey. Lawmakers and patient advocates say this means some patients are on the hook for hundreds or even thousands of dollars in out-of-pocket costs. Others go without the testing that may connect them with lifesaving treatment.
That would all change under a bill that’s headed to Gov. Phil Murphy’s desk to be signed into law. The legislation requires all health insurers to provide coverage for biomarker precision medical testing when patients need it.
“By requiring health insurers to provide coverage, we are breaking down barriers to early detection and targeted treatment, ultimately improving health outcomes for countless individuals across New Jersey,” said Assemblywoman Shavonda Sumter, D-Passaic, one of the legislation’s sponsors, in a press release.
Biomarker testing is a form of precision medicine that analyzes a patients’ cells to provide insights into their health status and risk of certain diseases. It can also help determine the right treatment at the right time by matching patients with targeted therapies, which may help patients avoid treatments that will be ineffective or unnecessary.
Multiple myeloma survivor Regina Toomey Bueno received biomarker testing during her treatment and testified before the Senate Commerce Committee in December 2024. The testing showed that her multiple myeloma was not particularly aggressive, meaning she would likely respond well to first-line treatment, Bueno told NJ Advance Media.
“That’s exactly what happened. I went into remission six months after I started treatment,” said Bueno, of Mahwah.
She credits biomarker testing with helping her avoid more painful, unnecessary procedures.
“In the past, everyone who got multiple myeloma got a stem cell transplant, also known as a bone marrow transplant. But because I responded the way I did and because they knew my type was not so aggressive, I didn’t have to do this very expensive, horribly invasive procedure,” said Bueno.
In a 2020 study sponsored by CVS Health, patients who received broad panel biomarker testing experienced an average additional up-front cost increase of $1,200 compared to patients who received narrow panel biomarker testing, with a cost savings of about $8,500 per month in total cost of care, a substantial overall savings in treatment costs over time.
Despite the proven savings and efficacy of biomarker testing for cancer treatment, studies show Black patients are less likely to receive these tests compared to white patients.
“If this bill were to get passed, more patients will get access to the right treatment at the right time and we believe that this bill will lead to potential lifesaving treatments for patients,” said Quinton Law, the New Jersey government relations director for American Cancer Society Cancer Action Network.
“And most importantly it’s going to close existing equity gaps. This moves us closer to a future where lifesaving care isn’t based now here you live or how much money you make,” said Law.
Biomarker testing also extends beyond cancer care. The science is being used in the treatment of other diseases including arthritis, autoimmune conditions, organ and tissue transplant, rare diseases, and preeclampsia. There is also biomarker research happening in Alzheimer’s, multiple sclerosis, cardiology and more.
The legislation in New Jersey has received support from over two dozen organizations, including the ALS Association, Alzheimer’s Association, the Arthritis Association, the National Organization for Rare Diseases, and the New Jersey State Society of Physician Assistants.
Dozens of states have made expanded biomarker testing part of their insurance laws. If the bill is signed by Murphy, New Jersey would become the 21st state to enact biomarker testing legislation, following in the footsteps of its neighbors in New York and Pennsylvania.
Stories by Jackie Roman
Thank you for relying on us to provide the journalism you can trust. Please consider supporting NJ.com with a subscription.
Jackie Roman may be reached at jroman@njadvancemedia.com.