Insurance Coverage Lags as Cancer Science, Treatment Move Forward

Insurance coverage is often slower than cancer science, according to a case described by KFF Health News involving 21-year-old Mason Henderson and a rare brain tumor. After his initial diagnosis, Henderson’s cancer spread to spinal fluid and he tried a three-week clinical trial in New York City. In early 2025, doctors chose olaparib (Lynparza) made by Merck and AstraZeneca, using the tumor’s genetic “language” to guide treatment. His insurance, however, denied coverage through Liviniti’s pharmacy benefit manager, rejecting the drug on Jan. 30 because it was “not approved for the diagnosis provided.” The article says the out-of-pocket cost was about $8,700 per month, while experts argue genomic testing often outpaces reimbursement rules.