Genomic Testing Costs Not Always Addressed by Oncologists, Survey Says

Conversations about the financial realities of genomic testing are not always taking place, according to a new study by the American Cancer Society.

Oncologists and patients across the country have a growing library of genomic tests and precision medicines targeting their cancer.

These options come with sometimes daunting costs. But the conversations about the financial realities of the cutting-edge cancer treatments are not always taking place, according to a new study by the American Cancer Society. 

“Interventions targeting modifiable oncologist and practice factors, such as training in genomic testing and use of electronic medical record (EMR) alerts, may help improve cost discussions about genomic testing and related treatments,” according to the paper, published in JNCI: The Journal of the National Cancer Institute.

The findings are based on the 2017 National Survey of Precision Medicine in Cancer Treatment, and focus on 1,220 oncologists who reported discussing genomic testing with their patients. 

About one-quarter of the oncologists (23.7%) reported never or rarely discussing the costs of genomic testing or precision medicine. Another quarter (26.3%) reported sometimes discussing costs. Meanwhile, half (50%) said they often discussed likely costs. 

The authors used multivariable polytomous logistic regression analyses to look at the various factors and associations, according to the paper. 

The oncologists who had training in genomics (OR, 2.09; 95% CI, 1.19-3.69) or who worked in places with EMR alerts for genomics tests (OR, 2.22; 95% CI, 1.30-3.79) more often had cost discussions.

“Other factors statistically significantly associated with more frequent cost discussions included treating solid tumors (rather than only hematological cancers), using next-generation sequencing gene panel tests, having higher patient volume, and working in practices with higher percentages of patients insured by Medicaid, or self-paid or uninsured,” the authors added. 

The paper concluded that adding “modifiable physician and practice factors” could be instituted into helping doctors and patients talk more frequently about the financial realities of the latest treatments. 



Yabroff K, Zhao J, de Moor J, et al. Factors associated with oncologist discussions of the costs of genomic testing and related treatments. J Natl Cancer Inst. doi:10.1093/jnci/djz173.