Private Payer and Medicare Coverage Policies for Use of Circulating Tumor DNA Tests in Cancer Diagnostics and Treatment.

ABSTRACT:

Background

Circulating tumor DNA (ctDNA) is used to select initial targeted therapy, identify mechanisms of therapeutic resistance, and measure minimal residual disease (MRD) after treatment. Our objective was to review private and Medicare coverage policies for ctDNA testing.

Methods

Policy Reporter was used to identify coverage policies (as of February 2022) from private payers and Medicare Local Coverage Determinations (LCDs) for ctDNA tests. We abstracted data regarding policy existence, ctDNA test coverage, cancer types covered, and clinical indications. Descriptive analyses were performed by payer, clinical indication, and cancer type.

Results

A total of 71 of 1,066 total policies met study inclusion criteria, of which 57 were private policies and 14 were Medica

SUBMITTER: Douglas MP 

PROVIDER: S-EPMC10846388 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature