BRCA1/2 testing landscape finds dropping prices

Thu Oct 15, 2015

Dear Colleagues,

Fall is a time of “reflection,” and we’re excited to report of all the work TRANSPERS has done over the summer. In this newsletter, we reflect on work completed by TRANSPERS including recent publication of an article using the initial data from our developing Payer Coverage Policy Registry, a scoping review on the economic evidence of identifying clinically actionable findings with whole genome sequencing, our ongoing work with the Patient-Centered Outcomes Research Institute, a series of papers on Gene Expression Profiling from our University of Calgary collaborator and recent publications since our last newsletter.

As always, we welcome your thoughts, comments, and ideas for collaboration.

Best,

Kathryn Phillips signature

Kathryn Phillips, PhD

TRANSPERS Center Director

In this issue

TRANSPERS payer coverage policy registry update: new publication in Nature Biotechnology on BRCA1/2 testing landscape finds dropping prices but lack of coverage for multi-gene panels

TRANSPERS is developing a Payer Coverage Policy Registry that systematically synthesizes payer coverage policies on multi-gene panels in order to be able to assess when payers cover panels, how panels are included in payer policies, and how this is changing over time. Our Registry is unique in its focus on coverage policies, inclusion of a wide range of key factors that influence coverage, and objective analyses by a non-profit academic institution.

TRANSPERS collaborators conducted the first review of the BRCA1/2 testing landscape since the historic 2013 Supreme Court decision that allowed the entry of new testing providers. We found that prices for single gene and multi-gene panels including BRCA1/2 have dropped, but that panels are not being covered by most insurers. The manuscript was published in the 9/8/2015 issue of Nature Biotechnology. This is the first of several forthcoming manuscripts using data from the TRANSPERS Payer Coverage Policy Registry.

TRANSPERS finds that cost-effectiveness of most clinically actionable genetic findings that ACMG recommends for return has not been evaluated in economic studies

Following the publication of the American College of Genetics and Genomics (ACMG)’s recommendations for returning clinically actionable results from Whole Genome Sequencing, TRANSPERS researchers conducted a scoping review of the economic evidence on detecting these mutations. Identified studies addressed fewer than one-third (7 of 24; 29%) of the ACMG conditions. The cost-effectiveness of screening in the general population was examined for only 2 of 24 conditions (8%). We concluded that the cost-effectiveness of most individual genetic findings that the ACMG recommends for return has not been evaluated in economic studies or in the context of screening in the general population. The manuscript was published online 5/21/2015 in Genetics in Medicine.

TRANSPERS conducts interviews with experts for Patient-Centered Outcomes Research Institute

TRANSPERS Director Kathryn Phillips is currently working with the Patient-Centered Outcomes Research Institute (PCORI) developing potential topics for their research agenda on comparative effectiveness research and personalized/precision medicine. Her report of a series of expert interviews was presented by Joe Selby at The National Advisory Council for Human Genome Research (NACHGR) meeting held on September 21, 2015.

TRANSPERS collaborator-led research finds broad public support for test that helps determine if patients will benefit from chemotherapy

TRANSPERS Collaborators from the University of Calgary published a series of articles on attitudes toward personalized medicine and breast cancer. “What we are trying to determine in the overall research project is how the test is valued, and does it change decisions about chemotherapy - and thus, should the cost of the test be covered by the government for patients,” says Deborah Marshall, PhD, of the university’s Cumming School of Medicine. “We showed this test is highly valued and does influence decisions.” Recent articles from this study include:

  • Bombard Y, Rozmovits L, Trudeau ME, Leighl NB, Deal K, Marshall DA. Patients’ perceptions of gene expression profiling in breast cancer treatment decisions. Curr Oncol. 2014 Apr;21(2):e203-11.
  • Bombard Y, Rozmovits L, Trudeau M, Leighl NB, Deal K, Marshall DA. Access to personalized medicine: factors influencing the use and value of gene expression profiling in breast cancer treatment. Curr Oncol. 2014 Jun;21(3):e426-33.
  • Bombard Y, Rozmovits L, Trudeau M, Leighl NB, Deal K, Marshall DA. The value of personalizing medicine: medical oncologists’ views on gene expression profiling in breast cancer treatment. Oncologist. 2015 Apr;20(4):351-6.

More information on this study can be found on the University of Calgary U Today website: Study looks at attitudes toward personalized medicine and breast cancer. [link defunct]

TRANSPERS on the go - worldwide

TRANSPERS and its collaborators have presented our work all over the world in the past year including the Qatar Foundation Annual Research Conference in Doha, Qatar (Phillips), HTAi meeting in Oslo, Norway (Marshall, MacDonald), and Oxford University Resource Allocation Conference in Oxford, UK (Phillips). Julia Trosman and Christine Weldon also presented at the ASCO meeting in Chicago and Kathryn Phillips presented at the Mayo Individualized Medicine Conference in Rochester, Minnesota.

Additionally, TRANSPERS is happy to announce their Collaborator, Reed Johnson, will be presenting a plenary session at the Society for Medical Decision Making’s upcoming 37th annual meeting to be held on October 18–21, 2015 in St. Louis, Missouri.

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