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Independence Blue Cross to cover gene sequencing for cancer care

Test detects DNA mutations that might help decide optimal cancer therapy

Independence Blue Cross has become the first major insurer to cover next-generation whole genome sequencing for a variety of cancers.

The Philadelphia-based health insurer said it entered into an agreement with the company NantHealth and will offer coverage for a test that fully sequences thousands of genes, detecting DNA mutations that may serve as markers to help doctors make decisions about a patient's optimal cancer therapy.

The insurer will cover the test for eligible members with specific conditions including rare cancers, tumors in children, metastatic cancer where the primary site is unknown, and other cases in which conventional therapies have failed and patients are candidates for further therapy, the company said.

"Decisions around cancer care are complex and personal. We're focused on supporting Independence members and their oncologists by offering coverage for this innovative approach to treating cancer," Daniel J. Hilferty, president and CEO of the health insurer, said in the statement. "Whole genome sequencing is one more option to help inform a personalized, effective treatment plan." 

In addition, Independence has joined the National Immunotherapy Coalition, an initiative involving several drug companies that focuses on accelerating the potential of combination immunotherapy as the next generation standard of care in cancer patients.

Last year, President Barack Obama announced the landmark Precision Medicine Imitative, a proposed $215 million investment to advance precision or personalized medicine and use genomics to customize patient treatment. Despite that push, precision medicine faces hurdles from reluctant payers, as Medicare and some private insurers have been skeptical about reimbursement for genetic testing. Some payers believe that genetic tests could lead to more expenses or care that won't improve patient outcomes.

Partnerships between precision medicine companies and insurers have been occurring, however, and could determine the viability of such tests as commercial products. Foundation Medicine recently announced that UnitedHealth has started covering its genetic test for patients with a certain lung cancer.

To learn more:
- read the announcement

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