Gene screen eyes mainstream
Posted: February 9, 2014 at 8:41 am
Genome sequencing holds great potential for diagnosing diseases, finding treatments and ultimately cutting medical costs, experts say, but insurance companies are leery of covering the still-new procedure, preventing it so far from becoming a routine part of medical care.
Boston-based Partners HealthCare is one of just two systems in the country to offer full genome sequencing for clinical patients. The out-of-pocket cost of unlocking your full genetic code, though, is steep: $9,000.
Cost is a barrier, said Heidi Rehm, chief laboratory director at the Partners Center for Personalized Genetic Medicine in Cambridge.
The lab started offering full genome sequencing last August using blood samples to extract information from DNA but it has done the complex analysis for fewer than half a dozen patients since then. Insurance companies didnt cover the costs for any of those patients, Rehm said.
For patients suffering from a range of diseases, from cancer to hearing loss, sequencing can help identify the gene causing the problem and help doctors determine which treatments will be most effective. Genetic sequencing can also tell patients if theyre at risk of developing certain conditions later in life.
The challenge for scientists like Rehm is to prove that this kind of analysis is useful not just for sick patients but for healthy ones.
Can I say every patient should get their genome sequenced? We just dont have the collective evidence and the studies to prove that today, Rehm said. So the insurers are not going to cover everything today.
Insurance companies do pay for some genetic tests those that test specifically for a patients risk of developing breast cancer, for example but theyre still evaluating the benefit of full genome sequencing, which involves much more data and analysis.
We dont have a lot of information yet to make sweeping decisions, said Dr. Neil Minkoff, medical director for the Massachusetts Association of Health Plans. We tend to look at the individual patient or individual physicians request. Its still early in our experience with it.
The states three largest insurers, Blue Cross Blue Shield, Harvard Pilgrim Health Care and Tufts Health Plan, did not respond to requests for comment.
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Gene screen eyes mainstream
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