Highmark Inc. approves new blood test for targeted treatment of non-small cell lung cancer

PITTSBURGH (Sept. 28, 2020) — After two years of study and evaluation, the Highmark Health Plan medical policy team has approved a new kind of blood test that helps oncologists diagnose and treat patients with non-small cell lung cancer (NSCLC).  Because lung cancer remains the leading cause of cancer death in the United States according to the American Cancer Society, this is a significant policy change. Highmark is among the first insurers to approve the Biocept test, a type of liquid biopsy.

When a patient has already been diagnosed with NSCLC, this liquid biopsy test is used to determine which kind of therapies will be used to target cancer cells with specific genetic mutations. A liquid biopsy allows treatment based on a blood test where previously an invasive biopsy would have to be performed.

The research and study the past two years was managed by Highmark Health’s VITAL Innovation Platform. VITAL tests  early-stage health innovations, producing evidence related to patient experience, care, and cost outcomes so that promising health solutions can potentially be adopted by health plans and improve members’ lives.

“This is an example of how Highmark is a leader in many areas and where collaboration has worked really well. The VITAL team worked with the physicians at the Allegheny Health Network and also the Highmark Health Plan team, along with our medical policy vendor, eviCore, to make certain this could work for patients,” said David Webster, M.D., vice president and executive medical director for the Highmark Health Plan. “After several years, the data shows this will help oncologists better target treatment.”

While much of this testing and management took place in western Pennsylvania, Highmark’s medical policy change is effective for all regions, including the core markets that Highmark and its affiliates serve in Pennsylvania, West Virginia and Delaware.