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Insurance Now Must Cover More Cancer Tests

DES MOINES — Cancer survivors were on hand Wednesday to watch Iowa Gov. Kim Reynolds sign into law legislation that will require insurance companies to cover diagnostic exams designed to detect cancerous tumors in dense breast tissue, and biomarker testing that tests for cancer and other diseases.

Reynolds signed both bills into law during a ceremony at the Iowa Capitol. Both bills received strong bipartisan support during the legislative process: combined there was only one vote in opposition.

The new laws take effect as Iowa's cancer rate has soared to be the second-highest in the nation, trailing only Kentucky.

"This is a huge day," said Maria Steele, a 66-year-old Adel woman who was diagnosed with Stage 4 lung cancer four years ago and underwent biomarker testing to help determine her treatment.

Steele, whose granddaughter, Penelope, sat on Reynolds' lap as the Republican governor signed the bill into law, said she had to work with her physician and insurance company to ensure the company paid for her biomarker testing, which she said cost $8,200.

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Steele, who also has worked as a nurse practitioner, said she worries not everyone would know to fight for insurance to cover that. Now, companies will have to cover it under state law.

Steele said biomarker testing is like a GPS system that helps physicians determine the best possible treatment.

"It's the right treatment for the right patient at the right time," she said. "So you're going to get right the treatment and typically fewer side effects then traditional chemotherapy.

"But more importantly, on a personal level, your quality of life is so much better. I was told that statistically I had a year to live, four years ago," Steele added. "I've been able to spend time with my beautiful family … and I don't think you can put a price on that."

Reynolds became emotional when she noted that her family has firsthand experience with biomarker testing. Reynolds' husband, Kevin, was diagnosed with lung cancer in October 2023.

"We personally got to use it, so I can tell you that it definitely makes a difference and it really ties the treatment to a specific marker," Gov. Reynolds said. "So it really does matter."

Kimberly Pearson, a 49-year-old breast cancer survivor from Oskaloosa and a nurse at Pella Regional Health Center, said requiring insurance companies to cover diagnostic breast exams will give Iowans free access to a test that can reveal more than a mammogram.

"If you have dense breast tissue, a mammogram may not see a mass in your breast until it's quite large. It's kind of like a cloudy picture," Pearson said. "A breast MRI is much more sensitive, much easier to see through that dense tissue. So you can find tumors when they're much smaller and early, and much less life-threatening, much easier to treat."

House File 2668, the biomarker testing bill, passed the Iowa Senate 46-0 and the Iowa House 97-1. House File 2489, the diagnostic breast exam bill, passed the Iowa Senate 47-0 and the Iowa House 97-0.

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Insurance Must Cover More Tests For Cancer Under New Iowa Laws

With Penelope Steele of Des Moines sitting in her lap, Iowa Gov. Kim Reynolds on Wednesday signs into law during a ceremony in the Iowa Capitol in Des Moines legislation that will require insurance companies to cover biomarker testing. (Erin Murphy/The Gazette)

The new laws take effect as Iowa's cancer rate has soared to be the second-highest in the nation, trailing only Kentucky.

"This is a huge day," said Maria Steele, a 66-year-old Adel woman who was diagnosed with Stage 4 lung cancer four years ago and underwent biomarker testing to help determine her treatment.

Steele, who also has worked as a nurse practitioner, said she worries not everyone would know to fight for insurance to cover that. Now, companies will have to cover it under state law.

Steele said biomarker testing is like a GPS system that helps physicians determine the best possible treatment.

"It's the right treatment for the right patient at the right time," she said. "So you're going to get right the treatment and typically fewer side effects then traditional chemotherapy.

Reynolds became emotional when she noted that her family has firsthand experience with biomarker testing. Reynolds' husband, Kevin, was diagnosed with lung cancer in October 2023.

"We personally got to use it, so I can tell you that it definitely makes a difference and it really ties the treatment to a specific marker," Gov. Reynolds said. "So it really does matter."

Iowa Gov. Kim Reynolds on Wednesday signs into law legislation that will require insurance companies to cover diagnostic breast exams during a ceremony in the Iowa Capitol in Des Moines. (Erin Murphy/The Gazette)

Comments: (515) 355-1300, erin.Murphy@thegazette.Com

Merck Reports Progress On The Cancer Front As It Prepares For Keytruda Patent Expiration

After topping expectations with first quarter revenue and adjusted earnings last week, Merck & Co Inc (NYSE: MRK) just reported encouraging data from its Phase III gastric cancer treatment trial after ending 2023 with good news from its combined treatment with Moderna Inc (NASDAQ: MRNA) in fighting melanoma.

Merck reported improvement in cancer patients receiving its Keytruda regimen.

Enrolling 698 subjects, the trial evaluated the effect of a treatment that combines Merck's immunotherapy blockbuster, Keytruda, along with trastuzumab and chemotherapy on patients suffering from gastric or gastroesophageal junction (GEJ) adenocarcinoma. The final also confirmed that Merck's Keytruda combination regimen led to a statistically significant and clinically meaningful improvement, meeting the dual primary endpoint of overall survival.

Merck reported strong first quarter results.

With strong sales of its blockbuster immune-based cancer drug, Keytruda, along with vaccine products, Merck reported revenue rose 9% YoY to $15.78 billion, surpassing LSEG's estimate of $15.20 billion. Net income for the first three months of the year amounted to $4.76 billion, or $1.87 per share. Excluding acquisitions and restructuring costs, adjusted earnings amounted to $2.07 per share, surpassing $1.88 per share that LSEG expected.

The pharmaceutical unit reported revenue grew 10% YoY to $14.01 billion, with Keytruda alone bringing in $6.95 billion of those sales as its revenue grew as much as 20% YoY, surpassing even FactSet's estimate of $6.71 billion. The rise is owed to increased uptake from cancer patients at earliest stages of cancer, along with continued demand for treating metastatic cancers. HPV prevention vaccine, Gardasil, also reported a 14% YoY rise in sales as it brought $2.25 billion to the revenue table. Pneumococcal disease prevention vaccine, Vaxneuvance, also posted remarkable growth of 106% YoY as sales amounted to $219 million.

On the other hand, Covid antiviral pill Lagevrio and Type 2 diabetes treatment Januvia, reported sales dropped. Lagevrio reported sales dropped 11% to $350 million, joining the same trend posted by Pfizer and Moderna as COVID-19 now seems to be history. Januvia posted a 24% YoY drop in sales as revenue amounted to $670 million due to falling demand in the U.S., lower prices and generic competition.

New deals and drug launches to offset Keytruda's patent expiration.

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All in all, Merck showed it is making substantial progress in preparing for 2028's patent expiration of its blockbuster drug, which will likely dent sales. Besides Winrevair that has been approved in the U.S. last month for treating progressive and life-threatening lung condition. In December, Merck and Moderna presented positive results from the combination of Keytruda and their experimential mRNA vaccine for melanoma, halving relapse risk. Although it was mid-term data from the 3-year follow-up, Merck and Moderna provided hope that mRNA could revolutionize cancer treatment. Moderna director, Stéphane Bancel, hinted that the mRNA vaccine for melanoma could be available as early as 2025. Moreover, after these promising results, Moderna and Merck expanded their research scope to evaluate the effect of the treatment against non-small lung cancer.

mRNA already saved the world during the unprecedented COVID-19 crisis and now, it promises to do the same with what seems to be pharma's never-ending health-battle. Keytruda's patent will expire but Merck did all it can to make sure it continues to contribute to a healthier society. Along with cutting costs under a restructuring program it kicked off in February, Merck is securing its financial existance and future with new deals and promising drug launches.

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