Many health advocates applauded Angelina Jolie for encouraging women to undergo genetic testing to familiarize themselves with predisposed cancer risks.
While testing can help warn of dangers and potentially save lives, many of the major health insurance companies are refusing to pay for the procedures.
Aetna, Anthem and Cigna, three of the four largest health insurers in the nation, decline coverage for these multi-gene panel tests, according to a new report issued by
Reuters.
The tests, which are able to examine more than 20 genes at a time, cost between $2,000 to $4,900 per patient. They allow medical professionals to link DNA to possible future cases of cancer-related illnesses.
Women can then take precautionary measures to reduce their likelihood of developing the disease, which range from implementing a better diet to receiving a double mastectomy and removing ovaries, as Jolie did.
Not all insurers are denying coverage, however. Kaiser Permanente offers testing for women with a family history of cancer, arguing that advanced knowledge of risks can foster cost-saving prevention efforts.
“If we have members who are not being tested in a timely manner, we know that their risk of cancer in the long run costs us and them a lot more,” Susan Kutner, a Kaiser Permanente hospital surgeon on the U.S. Centers for Disease Control and Prevention advisory committee on young women and breast cancer, told
Reuters.
In addition, the Affordable Care Act requires all health care providers to cover examinations for BRCA1 and BRCA2, as well a few other supplemental genes, for women who have instances of cancer in their family genetics.
While the “Angelina effect” has caused a 40% spike in women who receive BRCA testing, according to the AARP Public Policy Institute, insurers feel that the connection between DNA and cancer probability right now is tenuous, and doesn’t warrant coverage of the more comprehensive panel tests.
They also contend that these analyses could lead to women taking unnecessary undergoing unnecessary medical imperatives, such as radiation or surgery.
Still, as cancer research advances, practitioners will have a better idea of the genetic inclinations toward the disease, which may spur insurance companies to further coverage.
In fact, Carin Espenschied, a senior products manager at Ambry and genetic counselor told
Reuters that the medical community is moving towards incorporating more genes in their testing protocols, and that insurance companies “…kind of just have to catch up.”
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