Dive Brief:
- Michigan-based health plan Priority Health has announced it will cover comprehensive genomic profiling under specific circumstances for subscribers who are diagnosed with aggressive or difficult-to-treat forms of cancer.
- The company claims to be the first in the US to cover this all-inclusive genetic testing, while others more typically cover individual tests for specific markers.
- Priority Health says the purpose is to better serve those who don't necessarily have time to undergo a series of tests for specific gene markers, and more quickly target the best potential treatment options. The testing will also provide information to determine whether a patient is eligible for clinical trials, which often require participants to have a specific genetic marker or mutation.
Dive Insight:
The concept of comprehensive genomic testing is divisive. According to Blue Cross Blue Shield of Michigan, Priority Health's top competition, current research hasn't demonstrated proven benefits to wide-spectrum genetic testing.
"Selective genetic testing is covered by Blue Cross Blue Shield," Dr. George Kipa, deputy chief medical officer of Blue Cross Blue Shield of Michigan, told the Traverse City Record-Eagle. "For specific cases that have been shown to be useful and actionable, we cover genetic testing."
According to Kipa, whole-spectrum genomic testing has a "low level of reliability."
Blue Cross Blue Shield of Michigan has certainly been investigating the research. The insurer reportedly held a series of conferences in 2014 that led to the development of The Genetic Testing Resource and Quality Consortium, which the company funds, and coordinates through the Department of Pathology at the University of Michigan Medical School.