Policy Priority: Guidelines and Compendia as Health Policy Tool

Clinical Practice Guidelines as a Policy Resource to Ensure Access to High-Quality Cancer Care

As medical science advances and treatment options for cancer care expand, legislative and regulatory policies must be crafted to ensure relevancy of medical information and access to appropriate care. NCCN affirms that nationally-recognized, continuously-updated, clinical practice guidelines are a key component to protecting the durability and relevance of coverage policy in the midst of scientific and technological innovation. Adherence to NCCN Guidelines:

• Safeguards patient access to the highest standard of care;
• Improves patient outcomes and reduces disparities 1, 2, 3, 4, 5, 6;
• Reduces health care costs to both health systems and patients;
• Ensures relevancy of scientific information by remaining current through continuous updating; and
• Ensures transparency of NCCN Guidelines Panel composition and participation, decision methodology, and evidence.

Guideline concordant care safeguards patient access to the highest standard of care available, improves outcomes, reduces disparities in care, and reduces costs to the health system and individual patient. As coverage policy adapts to therapeutic innovation, legislative and regulatory policies must protect the relevancy of medical information and access to appropriate care through nationally recognized, continuously updated, clinical guidelines and guideline-concordant care.

Biomarker Testing

The field of genomic testing is rapidly evolving but the evidence for clinical utility and accuracy is widely variable across the field of available laboratory developed tests (LDT’s) and known biomarkers. Given the evolving nature of evidence in this field, the tools used to determine coverage must be continuously updated. The NCCN Biomarkers Compendium^® is a tool developed to identify the appropriate use of biomarkers to screen, diagnose, monitor, and provide predictive and prognostic information for the treatment of patients.

Based directly on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®), the NCCN Biomarkers Compendium contains information designed to support decision-making around the use of biomarker testing in patients with cancer. It provides general information on appropriate methodologies for biomarker testing, focusing on the biology or abnormality being measured rather than on commercially available tests or test kits. The NCCN Biomarkers Compendium aims to ensure that patients have access to appropriate biomarker testing based on the evaluations and recommendations of NCCN Guidelines Panel members.

In order to ensure people with cancer receive optimally-targeted treatment according to the latest research, NCCN affirms that:

• Access to clinically-appropriate biomarker testing has significant impact on cancer risk, prevention, and treatment outcomes. As such, patients with or at risk for cancer should be given timely access to clinically-appropriate biomarker testing.
• The NCCN Biomarkers Compendium is a useful tool for policy makers to ensure patient access to evidence-based, clinically-appropriate biomarker testing