A culture of advocacy and promotion for aggressive testing may arise when a biomarker or its sequelae yield financial benefit to drug and device manufacturers, procedure-based specialties, hospitals, or laboratory testing services or is increasingly requested by patients. Excessive testing can also lead to costly and harmful care, including false-positive results, overdiagnoses, and unnecessary treatments. Economic pressures, obfuscated intentionally or inadvertently, can drive increased use of biomarkers, a phenomenon that could be termed “biomarkup.”