Streamlining Oncology Care Through Precision Medicine and Biomarker Testing: Daryl Pritchard, PhD

Access to precision medicine through tools like biomarker testing remains a challenge for patients and providers as coverage and institutional structures vary nationally. Precision medicine and ways to increase access, affordability, and implementation were key discussion topics at the Academy of Managed Care Pharmacy (AMCP) 2026 meeting in Nashville, Tennessee.

“Biomarker testing, despite its proven efficacy to streamline precision medicine, has also proven difficult to obtain for patients and health institutions alike,” Daryl Pritchard, PhD, senior VP of the Personalized Medicine Coalition, said in an interview with The American Journal of Managed Care^® (AJMC^®).

In this interview, Pritchard expands on the necessity of biomarker testing for the future implementation of precision medicine and positive patient outcomes in oncology.

This transcript was lightly edited for clarity.

AJMC: Precision medicine is rapidly advancing in oncology. Where do you see the biggest gaps today between innovation and real-world implementation?

Pritchard: We have found that the biggest gaps between innovation and implementation and clinical adoption of new tools are these operational institutional implementation practices that are providing clinical practice gaps in the delivery of personalized medicine. Even though we have terrific biomarker tests and targeted treatments for those patients who are responders to those biomarker tests, we're finding that the relatively more complex pathway to deliver precision medicine has a number of steps where patients keep losing out on receiving treatment.

The most important statistic I can give you is that we recently did a study that looked at all of the newly diagnosed lung cancer patients in the US and determined that only about 36% of them were able to get all the way through the personalized medicine precision oncology pathway to get the best treatment for them. However, 64% of patients newly diagnosed with lung cancer are dropping out at various implementation points across that pathway.

I bring up lung cancer because there's a very robust personalized medicine pathway associated with lung cancer, but this would probably be the case. And all of these implementation problems and clinical practice gaps would apply to all cancer types, wherein biomarker testing plays a role.

AJMC: You've highlighted fragmentation across the precision medicine ecosystem. What are the most critical areas where misalignment is impacting patient access and care quality?

Pritchard: It’s a relatively complex pathway, but there is fragmentation at various points along the delivery of precision oncology. I would say the most pronounced are the ones that are causing the biggest gap in patients receiving care, which is in 2 areas. The first is in ordering biomarker testing. This would seem like a surprise for many, but as many as 18% of newly diagnosed lung cancer patients, again—using lung cancer as an example—don't even get biomarker tests ordered. This is something we need to fix.

The other area that is most prominent is in the treatment decision-making. Even for those patients who've had biomarker testing and have had actionable results delivered to them, 30% of those patients are still not getting the appropriate treatment that aligns with their biomarker testing, and we need to fix that.

AJMC: How can payers, regulators, and clinical stakeholders better align coverage policies with evolving clinical evidence to support precision oncology?

Pritchard: One of the key reasons why biomarker testing might not be ordered, or a treatment decision might not be made that lines up with the biomarker testing is this idea of financial toxicity. If we had the appropriate incentives in place to make sure these technologies were covered and reimbursed adequately, then I think that would go a long way in assuring that patients have access to thisf care. It's a little bit more complicated, though, because testing comes with a cost, and targeted treatments are often somewhat more expensive than your standard treatments.

We need to address the offsets in those costs and provide the appropriate incentives for the industry and for payers to provide those coverage and reimbursement policies that align with the best practices in precision oncology medicine.

AJMC: Looking ahead, what policy or system-level changes would most accelerate equitable access to precision medicine and improve outcomes for patients with cancer?

Pritchard: I think the biggest drivers were the 2 things I mentioned prior. From a long-term perspective, it's really those quality measures, but from a short-term perspective, when we want to assure that patients get precision medicine, we need to include that reflexive testing and those clinical decision support tools directly linked to the electronic health record with those operational policies in place or operational procedures in place. I think we would go a long way to helping make sure that patients get the best care.