EviCore to cover Guardant Health’s Shield blood test for colorectal cancer screening. The expanded coverage will take effect January 1, 2027. Guardant Health, Inc. Announces Expanded Policy for Shield™ Blood Test . The company creates precision oncology solutions to detect and treat cancer. Evernorth will include Shield in the clinical guidelines of EviCore. Coverage will be per American Cancer Society guidelines for colorectal cancer screening.
EviCore is owned by Cigna and operates as a specialty benefits manager. The company is the second largest specialty benefits manager in the United States. Its operations span more than 23 states across the country. The latest policy will therefore expand access for a large number of eligible patients. The coverage expansion follows rapid commercial adoption of Shield. Guardant Health has reported significant growth in insurer coverage during the latest fiscal quarter.
Carelon and UnitedHealth Group also recently expanded coverage for Shield. Carelon is the largest specialty benefits manager in the United States. UnitedHealth Group is also the largest insurer in the country. Together, these coverage decisions have increased Shield’s covered population substantially. The total number of covered lives now reaches approximately 94 million. This figure includes adults aged 45 and older who meet screening eligibility requirements.
Shield remains the first FDA-approved blood test for primary colorectal cancer screening. It targets average-risk adults who require routine colorectal cancer screening. The expanded access comes amid growing concerns about colorectal cancer rates. Rates continue to rise among adults younger than 65. Mortality among younger adults has also increased. Colorectal cancer remains the leading cause of cancer death among people under 50.
“With the latest coverage from EviCore, an overwhelming majority of eligible Americans now have access to the most clinically-validated blood-based colorectal cancer screening option,” said AmirAli Talasaz, Guardant Health co-CEO. “Today’s expanded coverage from EviCore marks another critical milestone in our commercial expansion and rapid adoption by insurers as part of our broader mission to make screening more accessible for those who need it most.”
Shield Supports Wider Colorectal Cancer Screening
Guardant Health says Shield delivers strong performance in colorectal cancer detection. The company compares its performance with published FIT screening results. Shield is recommended by both the American Cancer Society and National Comprehensive Cancer Network guidelines. These recommendations further support its role in colorectal cancer screening. More than 200,000 Shield tests have been performed in real-world healthcare settings. The testing experience has also provided evidence around screening completion.
Shield has demonstrated increased overall CRC screening completion among eligible patients. This result has been observed across different practices and healthcare systems. The test has demonstrated more than 90% screening adherence. Therefore, the blood-based screening option can help address barriers to traditional screening approaches. Colorectal cancer screening remains an important part of early cancer detection. However, patients may delay or avoid recommended screening procedures.
Blood-based testing offers another non-invasive screening option for eligible adults. Consequently, broader insurance coverage could help more patients complete recommended screening. The latest EviCore policy will affect commercial payers across 23 states. These states include Arkansas, Alabama, Connecticut, and Georgia. The coverage also extends across Illinois, Indiana, Kentucky, and Louisiana. Maryland and Washington, D.C., are included within the policy area.
Maine, Missouri, Minnesota, and North Carolina are also covered. Nevada, New York, Oklahoma, and Pennsylvania are included as well. The policy additionally covers Rhode Island, Tennessee, Wisconsin, Wyoming, and West Virginia. As a result, eligible patients across these markets can gain access to Shield coverage. EviCore provides medical benefit management services for Blue Cross Blue Shield. It also supports other commercial payers across the United States. The new policy represents another step in the broader commercial adoption of Shield. It also strengthens access to blood-based colorectal cancer screening.
About the Shield Blood Test
Shield uses methylation partitioning cell-free DNA technology. The non-invasive test detects alterations associated with colorectal cancer in blood samples. The Shield blood test is intended for individuals at average risk of colorectal cancer. It is designed for adults aged 45 and older. However, Shield is not intended for individuals at high risk for colorectal cancer. Eligible patients can consider the test alongside other guideline-recommended non-invasive screening options.
The test can also be done when you see a health-care provider. This may offer more convenience for patients and health care providers. A positive Shield result is a concern for colorectal cancer or advanced adenoma. Those who test positive should then undergo evaluation with colonoscopy. The colonoscopy is an additional test after a positive blood-based screening test. Therefore, Shield is a screening tool and not an independent diagnostic test.
The latest EviCore coverage expansion strengthens the availability of this screening approach. It also reflects the growing role of blood-based testing in cancer screening. Guardant Health continues to expand commercial access to Shield across the United States. Meanwhile, insurers are increasing coverage for the FDA-approved colorectal cancer screening test.
The growing coverage base may help to increase the participation of eligible adults in routine CRC screening. It could also allow earlier detection by increasing access to non-invasive testing. “Overall, the EviCore policy is an important milestone for Guardant Health. The move further opens up Shield access to qualified American adults.
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News Source: Businesswire.com
