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. 2025 Jun;31(6-a Suppl):S1-S14.
doi: 10.18553/jmcp.2025.31.6-a.s1.

Optimization of oncology biomarker testing in managed care: Best practices and consensus recommendations from an AMCP Market Insights program

Diana Brixner  1 , Terry Richardson, Catherine M Lockhart  2 , Scott Ramsey  3 , John Fox  4 , Daryl Pritchard  5 , Howard Mcleod  6 , Laura Bobolts  7 , Brian Bourbeau  8 , Erin Crum  9
Affiliations

Optimization of oncology biomarker testing in managed care: Best practices and consensus recommendations from an AMCP Market Insights program

Diana Brixner et al. J Manag Care Spec Pharm. 2025 Jun.

Abstract

Precision medicine in oncology using actionable molecular biomarkers to guide treatment selection has been associated with favorable outcomes; however, many potentially eligible patients do not receive it. This Academy of Managed Care Pharmacy Market Insights program sought to characterize unmet needs in biomarker testing among managed care stakeholders, to develop best practice and consensus recommendations to support addressing these needs, and to gain insights on potential quality measures related to biomarker testing. The program used a modified Delphi process and included in-depth interviews with expert panelists, a national survey of managed care professionals, and a consensus survey of experts. Areas of unmet need in biomarker testing identified were education, guidelines and protocols, timeliness, process, and equity. Twenty-two best practices were suggested by managed care experts and other stakeholders; 9 of these best practices achieved consensus. These consensus recommendations addressed biomarker test ordering and test performance, treatment decisions based on biomarker testing, cost-effectiveness of biomarker testing, and health disparities in access to biomarker testing. Opportunities for education and improvements in infrastructure to implement these recommendations were identified. Further investigation is needed to develop quality measures; although, valuable insights were gained.

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Conflict of interest statement

Dr Brixner discloses support from Impact Education, LLC for the development of this article; consulting fees from Bayer, Eisai, Tandem, and Sanofi; payment or honoraria from Leo; and support for attending meetings and/or travel from Bayer and Leo. Dr Richardson discloses support for medical writing from AMCP made to Impact Education, LLC and support for attending AMCP meetings and/or travel. Ms Crum discloses employment by McKesson and The US Oncology Network, stock or stock options in McKesson, a grant from Johnson & Johnson to explore digital quality measure development for biomarker testing, membership on the American Society of Clinical Oncology (ASCO) Implementation Corp Committee, and membership on 2 Partnership for Quality Measurement committees (Measure Endorsement and Maintenance Committee and Pre-Rulemaking Measure Review Committee). Dr McLeod discloses consulting fees from the Viecure Clinical Advisory Committee, EviCORE medical advisory committee, and the Kansas Institute for Precision Medicine Advisory, as well as stock ownership in Clarified Precision Medicine and Genovation Health. Mr Bourbeau discloses a grant to ASCO from Pfizer and a fund contribution to ASCO and Conquer Cancer Foundation from Novartis. Dr Ramsey discloses employment and stock or other ownership interests in Curta Consulting, research funding to Fred Hutchinson Cancer Research Center from Bayer, and support for travel, accommodations, and expenses from Bayer. Drs Bobolts, Lockhart, and Fox have nothing to disclose.

AMCP conducted this Market Insights program and conceptualized this supplement with funding provided by Abbvie, Amgen, Genentech, and Illumina. Abbvie, Amgen, and Genentech manufacture targeted medications for the treatment of various cancers. Illumina develops DNA sequencing and array-based life sciences technologies for use in oncology, genetic and infectious diseases, reproductive health, and other disease states.

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