Everyone should have access to the benefits of precision oncology. However, bringing molecular profiling into clinical care within community settings remains a challenge. Although more and more biomarker-informed therapies are being developed, FDA-approved, and launched in the market, not all patients have access due to numerous barriers, ranging from accessing genetic testing to the uneven reimbursement landscape.

To further explore these issues, as well as solutions that health systems have started implementing, Canexia Health’s Brady Davis recently moderated a panel during the Precision World Medicine Conference (PMWC) in Philadelphia, leading the discussion around providing equitable access to molecular testing, from making the business case to reimbursement.

The panelists were:

  • Thuy Phung  | University of South Alabama
  • Michael B Datto M.D., Ph.D.| DUHS Clinical Labs, Duke University Health System, Clinical Laboratories
  • Peter Hulick, M.D. FACMG | Mark R Neaman Ctr. For Personalized Medicine, Northshore University Health System

Key takeaways from these experts include:


  • Patients living in rural areas or smaller cities have much less access to genomic testing: one panelist found that bringing testing in-house increased chances of getting tested to 85% (versus send-out testing at 55%).
  • Education and awareness are critical within every institution. Molecular Tumor Boards can be part of the solution and can be a powerful tool for informing decisions around what assays to bring in-house.
  • While bringing in large panels can be tempting, it’s a challenge for resource limited institutions. One panelist’s health system was willing and able to adopt a more focused and cost-effective panel to get started.
  • Integration of NGS data into EMR systems can take time, for one panelist almost 9 months. That integration delays the validation process. Speeding up EMR integration would be of great value.
  • Regarding reimbursement, payers are starting to understand that data is impactful, but more is needed to make the case for consistent policies.


At the end of the day, institutions looking to bring testing in-house must start with a clearly defined mission. Be strategic and don’t try to chase all of the different innovations in this rapidly evolving field. Gain support from the top, horizontally, and from the bottom up. And don’t be afraid to try. “It’s a dirt path, and you’re paving it as you go.”


For a deeper dive, watch Canexia’s Dr. Melissa McConechy discuss “Best Practices for Bringing Plasma Biopsy In-house” here.


Recent Resources


May 15, 2023

Poster sessions at AACR: a recap

We were grateful for the opportunity to attend and present at the AACR Annual Meeting last week, where three of our scientists highlighted some of the exciting work happening in our Vancouver lab.