In mid-October 2020, the Federal Joint Committee (G-BA) has decided that three more biomarker-based tests in breast cancer will be covered by the statutory health insurance. Since January 2020, the "Oncotype DX Breast Recurrence Score" test is already reimbursed in Germany with a tariff of €3,296.50.
Biomarker tests are intended to support the patient's decision for or against chemotherapy after an operation. These tests examine the activity of various genes in the cancer cells and thus can help to estimate tumor recurrence risk. Above all, they can be applied when clinical factors or tumor characteristics cannot be used to determine the women's individual risk of cancer relapse reliably.
The G-BA decision covers the application of the specific tests EndoPredict®, MammaPrint®, and Prosigna®. They supplement the application of the Oncotype DX Breast Recurrence Score®, which is already reimbursed by the statutory health insurance in Germany.
The decision will come into force after the Federal Ministry of Health's non-objection and publication in the Federal Gazette. The listed tests can be provided as outpatient services after the Evaluation Committee decides on the amount of reimbursement via the EBM (German Uniform Evaluation Standard).
The G-BA decision in German can be found here.
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