IPM Take
This report shows why biomarker testing cannot be treated as a checkbox. Even when tests enter guidelines, patients can still be missed because of workflow gaps, payer alignment, turnaround time, local champions and diagnostic capacity. The access failure is not always dramatic. Sometimes it is simply that the eligible patient was never tested at the right moment.
Executive Summary
IQVIA Institute’s March 2026 report, Advancing Precision Oncology: Trends in Oncology Biomarker Testing in the U.S., examines adoption of biomarker testing across non-small cell lung cancer, breast cancer, ovarian cancer and prostate cancer. The report finds that testing rates for established biomarkers have improved since 2020, approaching 95% in NSCLC, 80% in breast and ovarian cancer, and 75% in prostate cancer as of December 2024. IQVIA also warns that persistent gaps in testing, turnaround and implementation can still prevent eligible patients from receiving timely personalised treatment.
Why it matters
- Diagnostics / pathology: Need reliable testing workflows, turnaround standards and reporting systems so biomarker results reach clinicians before treatment decisions are made.
- Clinicians: Should ensure guideline-recommended biomarker testing is triggered early enough, especially when treatment eligibility depends on molecular results.
- Payers: Need coverage policies that support timely testing, not only access to the targeted therapy after eligibility has already been proven.
Before widespread precision oncology, cancer treatment eligibility was often based mainly on tumour site, stage and clinical characteristics. Now, eligibility increasingly depends on molecular results. That makes biomarker testing a gateway to treatment, not a side diagnostic step.
What has changed is that testing has become more common across major cancers, but not uniformly implemented. IQVIA reports strong uptake for established biomarkers in NSCLC and improving rates in breast, ovarian and prostate cancer. The report identifies three factors that help testing move into routine practice: strong clinical evidence together with FDA and payer alignment, inclusion in national guidelines, and institution-level advocacy through oncologists, pathologists and workflow integration.
The affected population is patients whose treatment eligibility depends on biomarker status. The problem is not only whether a test exists. It is whether the right patient is tested at the right time, whether the result is returned quickly, and whether the treatment pathway can act on it.
For IPM, the lesson is clear: the next access benchmark is not only whether a targeted therapy exists. It is whether every eligible patient is tested early enough for the result to change care.
