Health Insurers Refuse to Pay for New Cancer Screening

There has been a substantial increase in demand for testing to screen for genetic factors that make one predisposed to developing cancer. This is in part attributed to the revelation by Angelina Jolie in 2013 that she had a double mastectomy after genetic testing showed that she possessed certain mutations that are associated with a high risk for breast and ovarian cancer.

Improvements in testing since 2013 have also carried a higher price tag, however. The new tests, called multi-gene panel tests, analyze at least 20 genes at the same time, allowing physicians to determine DNA-related risk factors in the 23,000 human genes much sooner than previous methods. Panel tests can range in price from $2,000 to $4,900, which has health insurance companies concerned that many people will undergo the tests who do not have a family history of cancer and are therefore much less likely to carry cancer-causing mutations.

As a result, three of the four largest health care companies in the United States – Aetna, Anthem, and Cigna – are declining to pay for the preventive tests. Kaiser Permanente does offer its clients with a family history of cancer preventive screenings because, it argues, both patients and the company are better off in the long term.

“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,”

said Susan Kutner, a member of the Centers for Disease Control and Prevention advisory committee on young women and breast cancer. Other insurers argue that the tests are unproven and difficult to interpret, which could lead to unnecessary treatment. However, doctors say that without further testing and identification of unknown genetic mutations, it will be difficult to attain the medical knowledge necessary to interpret all of the genetic data.


Read more here – “Aetna, Cigna Balk as Angelina Effect Spurs Genetic Cancer Testing,” (Caroline Humer, Reuters)

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