Impact of the NCCN Biomarkers Compendium on Managed Care Pharmacy

In December 2012, the National Comprehensive Cancer Network (NCCN) announced the availability of its NCCN Biomarkers Compendium, a new tool developed to support decision making related to biomarker testing in oncology patients. Biomarker testing, commonly referred to as molecular testing, is performed to identify specific types of gene expression or mutations that may lead to particular diagnoses or treatment decisions for patients. Often, these tests are undertaken to assess risk, diagnose or classify disease, and/or assess potential response to therapy. By utilizing certain biomarker tests to identify the most appropriate patients for therapy, better patient outcomes may result. With the number of biomarker tests growing substantially (approximately 2,000 tests are on the market currently, with an additional 1,000 tests becoming available per year), a need existed to develop a tool to help providers and managed care organizations determine the clinical utility of these tests. In a December 2012 interview with representatives from NCCN, Senior Vice President of Clinical Information and Publications Joan McClure stated, “The use of biomarkers is evolving. We wanted to develop a compendium that would be an easy reference tool that would allow payers and physicians to determine if testing would be useful.” Andrew D. Zelenetz, Vice Chair of Medical Informatics, Department of Medicine, and Chief, Lymphoma Service at Memorial Sloan-Kettering Cancer Center, and Chair of the NCCN Guidelines Panel for Non-Hodgkin’s Lymphoma, added, “Biomarker testing should be used to establish accurate diagnosis and identify groups of prognostically useful patients and to support therapy decisions.” The NCCN Biomarkers Compendium provides information on biomarker testing that is referenced in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Within the tool, users are able to select specific guidelines, diseases, molecular abnormalities, and gene symbols. The subsequent search results contain fields that can be selected by users, such as specific indication of the biomarker test, the test itself, chromosome, what the test detects, methodology, specimen types, test purpose, guideline page with recommendation, and notes. From December 2012 to January 2013, Xcenda, a consultancy and business unit of AmerisourceBergen Specialty Group, conducted a survey with advisors who participate in Managed Care Network (MCN). The survey, which was fielded to medical and pharmacy directors, assessed the impact of the NCCN Biomarkers Compendium on managed care pharmacy decision making. Survey respondents represented 96 million covered lives from commercial (93.3%), Medicare (71.7%), and Managed Medicaid (56.7%) plans. The survey was initiated via a web-based format in December 2012, approximately 2 weeks after the NCCN Biomarkers Compendium became available. Surveys were concluded in mid-January 2013.