Dr Patricia Deverka Explains Next Steps Toward Medicare Coverage of Multicancer Early Detection Tests

Patricia Deverka, MD, MS, senior researcher, deputy director at the Center for Translational and Policy Research and Precision Medicine, University of California San Francisco, talks about the 2 main paths for multicancer early detection (MCED) tests to be covered by Medicare.

Transcript

What needs to happen for MCED tests to receive an endorsement by the USPSTF and/or Medicare coverage? Do you think one path is more likely than the other?

The Medicare population is obviously a logical target for MCED tests, given that advancing age is a powerful predictor of increased risk of cancer. I think there's really 2 possible paths to Medicare coverage. One would be facilitating passage of new legislation that creates a specific screening exception for MCED screening tests, and the second would be to get a US Preventive Services Task Force [USPSTF] rating of A or B. That's a pretty long process—highly evidence-based—and it's worth pointing out that, to date, the USPSTF has never had to evaluate a multicancer screening test. The paradigm is typically 1 test, 1 cancer, so [the process comes] with all those caveats.

It's also important to point out that, regardless of either of those 2 pathways, both of those strategies would still require a national coverage determination before Medicare beneficiaries would obtain access through traditional Medicare. In terms of which one is longer, both paths have tremendous uncertainty. Because of the reason that multicancer early detection is an unprecedented testing paradigm, I think it's really difficult to predict which 1 of the 2 pathways is more likely to succeed, but hopefully I've pointed out how they're interrelated.