Chris Cisar, Senior Director of National Accounts for Managed Care, reflects on the recent MolDX coverage policy for Prolaris, a prognostic indicator that identifies localized prostate cancer patients who can safely pursue active surveillance as a primary treatment modality.
Prolaris distinguishes between men with aggressive forms of prostate cancer versus those who do not have aggressive forms of prostate cancer. In understanding this information, you can reduce the number of patients who undergo overtreatment and also undertreatment. Determining the aggressiveness empowers the patient and physician to make the correct treatment decisions. The National Comprehensive Cancer Network (NCCN) now recommends in their prostate cancer treatment guidelines, that the use of tumor bases molecular assays such as Prolaris, should be apart of the initial workup and staging.
In addition to reducing overtreatment and undertreatment, adding precision to risk assessment also produces overall cost savings. In 2010, the annual spend on prostate cancer treatment was roughly 12 billion dollars. Unfortunately, 40% of that spend was found to be inappropriate and could have been avoided if patients had not been overtreated.
Results from Prolaris significantly impact the management of localized prostate cancer. In two separate real-world clinical utility studies involving more than 1,500 patients, the results indicated that:
- Crawford et al. reported that the Prolaris test resulted in a 50%
reduction in surgical interventions and a 30% reduction in radiation treatment.
- Shore et al. reported that the Prolaris test resulted in a 34% reduction in radical prostatectomies and a
39% reduction in primary radiation therapy.
Prolaris provides precise risk assessment, which leads to more accurate and more cost-effective treatment decisions.