Will Insurers Cover $700 for Myriad's Large Rearrangement Test Plus $3K for BRACAnalysis?

GenomeWeb features Ellen T. Matloff, MS in the conversation about "comprehensive BRCA" testing. Click on the above light blue link to view the full article at genomeweb.com

Expert from genomeweb.com

"Matloff acknowledged that NCCN support for BART testing should spur more coverage for the test, but she took issue with Myriad's business ethics. "Not including an essential part of the test in what they call Comprehensive BRACAnalysis [is] absolutely unacceptable," she said. "Now that the NCCN guidelines have backed up what all of us have said — that every patient who is a candidate for BRACAnalysis should also have BART — I think what the right thing to do would have been to combine this into one test."

Well before NCCN recommended BART, healthcare providers and patient advocates were urging Myriad to fold BART into BRACAnalysis as a single offering. Last year, after Myriad released data showing that a certain portion of deleterious mutations are missed by standard BRCA testing, a group of 200 genetics professionals, surgeons, oncologists, and nurses led by the Yale Cancer Center wrote an open letter to the company asking it to incorporate this large rearrangement analysis into its Comprehensive test at no additional cost (PGx Reporter 8/3/2011). "We wanted BART to be a part of BRACAnalysis but [Myriad] ignored that," Matloff said.

Even if most insurers cover BART testing, ultimately the decision is up to the patient and the doctor as to whether to order the additional diagnostic. The fact that Comprehensive BRACAnalysis doesn't include BART could result in confusion among healthcare providers and cause them to believe that the original test covers all the important markers associated with breast and ovarian cancer susceptibility.

"Despite the fact that improvements in genetics technology have dramatically reduced the cost of performing genetic testing, Myriad's price for this test has continued to go up further," Sue Friedman, executive director of the patient advocacy group Facing Our Risk of Cancer Empowered, told PGx Reporter over e-mail. "Further, I fear that women undergoing 'Comprehensive BRCA testing,' which does not include BART, could mistakenly think they had complete BRCA testing. It is unconscionable that Myriad is providing the test in two separate parts in order to gain maximum reimbursement.""