Discrepancies between payer coverage and consensus guidelines for personalizing hereditary cancer risk

Date:
Friday, May 3, 2019 6:00pm – 7:30pm
Conference:
Authors:
Emily Dalton, Greg Nogle, Holly Laduca, Jessica Profato, Jill Dolinsky, Lily Hoang, Nancy Niguidula, Patrick Reineke, Victoria Ellis
  • Comparison of HBOC genetic testing policies from three US insurers to NCCN v2.2019 medical management guidelines available for 16 genes identified that among insurers A, B, and C, 6(37.5%), 8(50.0%) and 15(93.8%) of the genes were covered, respectively.
  • On a patient level, limiting genetic testing to payer coverage resulted in unidentified mutations and missed opportunities to personalize cancer risk management in accordance with expert consensus.
  • This data supports the expansion of insurer genetic testing policies to include MGPT for patients at high-risk of HBOC.