In response to the thousands of  genetic and molecular tests being marketed, which consequently inundate health plans with reimbursement and policy coverage decisions, Oncology Analytics, Inc. has launched a clinical decision support tool for molecular and genetic testing that is simple and easy to use.  Oncology Analytics, Inc., www.oncologyanalytics.com, is a comprehensive oncology benefits management company serving health plans, providers, and patients in the U.S. market and Puerto Rico. 

 “Our goal is to make coverage decisions easy for health plans and provide guidance to providers on the most clinically appropriate tests”, says Oncology Analytics CEO Marc Fishman, MD. “I believe, as does Dr. Graeme Bolger, the head of our molecular and genetic testing program, that clinical validity, as well as clinical utility determined through evidence-based medicine, is the most critical component of coverage determination.”

Graeme Bolger, MD comments, “With literally thousands of genetic or molecular tests and panels being available to physicians in the U.S. and with the introduction of new tests occurring at a fast pace, Oncology Analytics provides a mechanism for both providers and health plans to validate their decisions through our new clinical decision support software.”

Molecular testing, or tumor profiling for precision medicine, is the latest focus of many researchers in the cancer community.  For a test to be considered appropriate it must show evidence that it will lead to treatment options for the patient and improve quality of care. If genetic or molecular test results do not alter physician decision making or produce clinical outcomes that are meaningful to the patient, then patients do not benefit from these types of tests.  If a patient’s treatment protocol can be changed to provide a better clinical outcome through valid test results, then the patient’s quality of life is improved.

Although clinical utility is a driving factor in coverage decisions, affordability of tests is also factored into the clinical decision support tool.  If two or more tests exists that determine the same clinical utility and decision making process, the most affordable test which is clinically valid will be available to physicians and recommended for coverage under the tool.  An added plus to Oncology Analytics’ molecular and genetic testing clinical decision support tool is that it allows for health plan specific pricing to be factored into the software. This is a definite advantage for health plans that have preferred testing providers. “The mission of Oncology Analytics is to assure that patients receive high quality, cost effective cancer care while minimizing administrative burdens for providers and health plans,” says Dr. Fishman. “Our primary concern has been, and will always be the patient.”