Angelina Jolie-driven surge in pricey genetic test requests has payers on edge
- Medical researchers have dubbed the increased demand for genetic testing the "Angelina effect" after actress Angelina Jolie.
- In 2013, Angelina Jolie made history when she went public with a double mastectomy undertaken after she found out that she had BRCA1 and BRCA2 gene mutations that substantially increased her risk of breast cancer. She then went on last month, to have an oophorectomy in order to avoid ovarian cancer.
- Of the four largest managed care companies, only Kaiser covers test panels for patients with family histories of cancer. In contrast, Aetna, Anthem, and Cigna Corp do not.
Although the Affordable Care Act mandates that insurance companies must cover BRCA1 and BRCA 2 testing, more comprehensive gene testing panels are available, which can tell patients about their risk of various types of cancer, beyond reproductive cancers.
However, these panel tests, which analyze 20 or more genes at once, cost between $2,000 and $4,000 a pop, so insurance companies are loathe to cover them for a large number of people. They point out that many of these tests are inconclusive and therefore have limited diagnostic value. On the other side of the argument, advocates say that knowing risk can help patients make lifestyle decisions to decrease risk.
There was a time not long ago, when it was difficult or nearly impossible to get coverage for BRCA testing. But the reality is that five percent of the 230,000 cases of invasive cancer are hereditary, and as the understanding of gene testing and its role in diagnosis evolves, insurance companies will most likely increase coverage.