Researchers find that not all patients will pay for genetic testing June 1, 2012 in Cancer More than one-fifth of people who have
received referrals to test for cancer-causing genes say they will only undergo
testing if their insurance covers the cost—just as more insurers are
instituting cost-sharing for medical services like genetic testing, according
to new findings from Fox Chase Cancer Center in Philadelphia released at this
year's 2012 Annual Meeting of the American Society of Clinical Oncology on
Saturday, June 2. Even though patients may pay thousands of dollars for some
types of genetic testing, if they learn they carry mutations that put them at
risk of other cancers in the future, that money will be well-spent, says study
author Jennifer M. Matro, M.D., a medical oncology fellow at Fox Chase.
Patients who are more at risk of certain cancers will know to schedule regular
screening and check-ups so they can catch tumors at their earliest stages, when
treatment is easier—and less expensive, she notes."Cancer care is becoming
more personalized, but there are costs to that," says Matro. "The
goal of genetic testing is to give patients the best opportunity to detect
their cancers earlier, which can save costs in the long run."But given how
expensive genetic testing can be, Matro recommends that researchers learn more
about which patients are most at risk and truly need testing, to spare those who
may not carry enough compelling risk factors. "We need to discover more
risk factors for genetic mutations, so we can spare those patients who really
don't need to pay for genetic testing.""Genetic testing is now
routinely integrated into cancer care," says Matro. If someone develops a
colorectal cancer, for instance, a reflex preliminary screening test is done on
the tumor to identify patients at risk for Lynch syndrome, which would put them
at risk for other gastrointestinal cancers, endometrial, and renal cancers,
among others. If the test is positive, the patient is then referred for
additional testing to diagnose Lynch syndrome. If the screen is negative, no
additional testing is done. This preliminary screen is generally covered by all
insurers, but patients may be asked to pay some of the cost if additional
testing is needed.To determine whether these costs affect patients' decisions
to obtain genetic testing, Matro and her colleagues at Fox Chase reviewed data
collected from 406 people whose doctors suspected they may have cancer-causing
mutations, based on their personal and/or family history.The researchers found
that 82 people—21.3%—said they would undergo genetic testing only if it was
paid for by their insurance. Among those willing to pay some out of pocket
costs, nearly 90% provided a limit for how much they would pay; most limited
out of pocket costs to $500 or less. Not surprisingly, people who were more
worried about their risk of cancer and had more positive attitudes towards
genetic testing were more willing to pay higher costs. Interestingly, women,
people who were less educated, and those with more first-degree relatives who
had cancer were less likely to agree to high co-pays for genetic testing.It's
likely in some cases that simple cost is the issue, Matro speculates, since
people with less education may also make less money, and women may not be the
primary bread-winners in their household, so have less access to money.
"It's counterintuitive that people with more relatives who had cancer
would be willing to pay less for genetic testing," she concedes.
"Perhaps they assume the test will be positive, so don't want to be
saddled with a hefty co-pay. Alternatively, they may feel confident navigating
the healthcare system after helping family members with cancer, and believe
they can handle whatever diagnosis they eventually receive."Provided byFox
Chase Cancer Center
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