This week's U.S. Supreme Court ruling against the ability to patent naturally-occurring DNA and genetic information could impact the decisions of individuals to receive the BRCA genetic tests for breast cancer risks, according to University of Minnesota experts.
The ruling ultimately prevented Myriad Genetics from holding exclusive rights to the genetic tests for the BRCA mutations that predict elevated risks of breast cancer. At least one competitor has already pledged to offer a competing test at a third of the price. That would bring the out-of-pocket cost from more than $3,000 to closer to $1,000.
Mary Ahrens, a genetic counseling expert at the U of M, said patients struggle with many issues when deciding whether to receive the genetic test, including the psychological consequences of knowing the result and the emotional hardship of spreading information about positive tests to relatives. But those difficult issues can be irrelevant for them until they know if health insurance is covering the cost.
"Lets put it this way," she said. "If an insurance company does not cover the cost, so the patient is out $4,000, that trumps everything."
Ahrens and the U's Dr. Richard King said insurance coverage is fairly broad for women who have already been diagnosed with breast cancer. Coverage remains variable of their relatives or of people with significant family histories of breast cancer.
If the out-of-pocket cost is slashed by half or more following this Supreme Court ruling, Ahrens said that could increase public interest in testing. She noted the cost is already greatly reduced (around $500) for relatives of women who have tested positive for a BRCA mutation.
"Once they identify what mutation in the family is associated with cancer," she said, "it's very easy to go in and test somebody for that mutation."
A key issue following the ruling will be whether insurance companies expand the conditions under which they cover testing for the BRCA mutations.
"Anything that is over a couple hundred dollars is expensive" for patients, Ahrens said. "The big issue is going to be insurance coverage."