Payor-genomics

  • by: |
  • 11/08/2005

Kudos to NY Times reporter Andrew Pollack on a first class piece about the immediate possibilities of pharmacogenomics — and the road blocks to achieving them; most notably the lack of enthusiasm from insurance companies. Here’s what Mr. Pollack has to say:

“Health insurers are in some cases balking at paying for pharmacogenetic tests. It might seem that insurers would welcome tests that allowed side effects to be avoided or drugs to be used only in patients who would benefit from them. A test for a single enzyme like 2D6 costs $100 to $500. Yet Blue Cross Blue Shield concluded that the usefulness of the metabolism tests was not established. In particular, the insurer said, there have been no prospective studies, in which some patients are given the test and others are not to see whether those who are tested do better.”

How unfortunate that the insurance industry (and if I generalize mistakenly, please let me know) remains caught up in a 20th century acute care model when our nation so desperately needs a laser beam focus on the chronic side of the health care equation. After all, that’s both the driver and the rationale behind Medicare modernization.

I guess the insurance industry didn’t get the memo.

Nice job Andy.

Here’s the web link to the full article:

http://www.nytimes.com/2005/11/08/health/08phar.html?8hpib

CMPI

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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