Patients Not Being Made Aware of Costs of Cancer Genomic Tests

Only about half of surveyed physicians report discussing the cost of cancer genomic testing with patients, according to a study published in the Journal of the National Cancer Institute.

Researchers identified 1,220 oncologists who participated in the 2017 National Survey of Precision Medicine in Cancer Treatment and reported discussing genomic testing with their patients with cancer. They assessed associations between oncologist and practice characteristics and the frequency of cost discussions.

Just half of respondents said they often discuss the likely costs of testing and related treatments, while 26.3% reported sometimes discussing costs, and 23.7% reported never or rarely discussing costs.

Past experience influences cost discussions

Oncologists were more likely (defined as “sometimes” and “often”) to discuss costs if they had trained in genomic testing (odds ratio [OR] = 2.09; 95% CI, 1.19-3.69) or worked in practices with electronic medical record (EMR) alerts for genomic tests (OR=2.22; 95% CI, 1.30-3.79). Other factors statistically significantly associated with more frequent cost discussions included treating solid tumors (rather than hematologic cancers), using next-generation sequencing gene panel tests, having higher patient volume, and working in practices with higher percentages of patients insured by Medicaid, or self-paid or uninsured.

“Interventions targeting modifiable oncologist and practice factors, such as training in genomic testing and use of EMR alerts, may help improve cost discussions about genomic testing and related treatments,” the authors concluded.