Op ed: Now is the Time for North Carolina to Lead in Medical Innovation

By: John Scagnelli, MD and the North Carolina Neurological Society

John Scagnelli, MD and the North Carolina Neurological Society

In this era of medical innovation, some of the most powerful technologies aren’t new drugs or devices, but new tests. Advanced diagnostics are becoming personalized – like biomarker tests, which analyze patients down to the molecular level and enable clinicians to personalize each person’s treatment plan. 

Early detection of diseases means doctors and patients can create a care plan sooner, rather than later. That’s why more than 20 states have already passed legislation requiring health insurers to cover biomarker tests.

This year, the North Carolina House of Representatives passed legislation requiring health insurers to cover biomarker testing. Now the Senate has the chance to pass this life-changing legislation for all North Carolinians. 

Why should our state senators pass this legislation? 

First, biomarker testing works. While it sounds like something from science fiction, it has been a standard of care for certain cancers for over a decade. Studies show biomarker-driven care increases cancer patient survival rates, steers patients to effective treatment options, and reduces costs. 

In less than a generation, biomarker testing and personalized medicine have revolutionized oncology care. About half of all new cancer drugs developed this century, and three-fifths in recent years, are therapies that require advanced diagnostics. 

This revolutionary medical testing, which has improved cancer care, is now expanding into other medical specialties. Neurology is no exception.

Before 2025, diagnostic options were very limited for patients who were early in disease progression. In 2025, the first biomarker blood-protein test for Alzheimer’s was FDA-approved, providing us with a tool to help identify Alzheimer’s more effectively and less invasively than traditional tests. Biomarker tests such as this can help neurologists identify patients earlier in the disease and help identify patients most likely to benefit from advanced, disease-modifying therapies.

Furthermore, biomarkers are aiding in the fight against multiple sclerosis, or MS. A biomarker spinal fluid test has helped to isolate a key biomarker associated with MS activity, relapses and progression. In time, tests like this could help guide personalized MS treatments that slow or suppress the disease’s progression.

Every year, new biomarker tests are emerging that can revolutionize the care of other neurological disorders, from diseases like Parkinson’s, Lou Gehrig’s, and Huntington’s to traumatic brain injuries.

With these tests — and new ones in development— all North Carolinians should have access to the care they deserve. In progressive neurological diseases, every moment counts. Delayed diagnoses can cost patients and their families quality time together and additional financial burden. By the time late diagnoses are made, treatment options have often narrowed.  

North Carolina remains a national leader in biomarker science. UNC, Duke, and N.C. State all feature biomarker research labs and programs on their campuses, including a joint project focusing on Alzheimer’s. If North Carolina lawmakers support biomarker research, they should also ensure residents can access the benefits.

Today, too many people cannot get the biomarker tests they need simply because of their insurance coverage. We must do better, and right now, North Carolina’s General Assembly has the opportunity.

House Bill 567, ‘Ensure Access to Biomarker Testing’, would require all health insurers in the state — private insurance, Medicaid, and the State Health Plan — to cover all biomarker tests a physician deems medically appropriate. The logic of this bill is morally and medically clear: the patient-doctor relationship, not red tape, should guide all patient care. 

The prevalence of neurological disorders is set to explode in the coming years as our population ages. We need to be ready to meet that challenge with the appropriate medical tools.

North Carolina is already a leader in biomarker research. Now is the time for the North Carolina Senate to follow the House of Representatives’ lead and guarantee access to biomarker testing for all North Carolinians.