By Lisa Seachrist
WASHINGTON — Myriad Genetics Inc. will provide genetic susceptibility testing for breast and ovarian cancer for members of the Aetna U.S. Healthcare insurance plan.
Under a multi-year deal with Blue Bell, Pa.-based Aetna, Myriad Genetics will provide referred patients with BRACAnalysis breast and ovarian susceptibility testing. BRACAnalysis provides full sequence information for two genes associated with the risk of developing breast or ovarian cancer.
"I think [this deal] is an important milestone in establishing that genetic testing for breast cancer susceptibility is necessary and appropriate in certain cases," said William Hockett, director of corporate communications for Salt Lake City-based Myriad. "It's very satisfying this is taking place. It's important for society."
In addition, Myriad noted in its news release on the Aetna deal that the "confidentiality of patient test results will remain absolute. No patient test result information will be provided to Aetna by Myriad Genetics unless the patient specifically requests, in writing, that Myriad release the information."
Aetna was not available to describe details of the confidentiality agreement by press time; however, one of the stumbling blocks for widespread use of genetic susceptibility testing has been the fear that it could result in the inability to obtain affordable health and life insurance.
Concern over the issue is so great Congress has proposed several bills that would offer protections for genetic information. (See BioWorld Today, May 22, 1998, p. 1.)
The Myriad test provides full-length sequence analysis of both BRCA1 and BRCA2 genes. Mutations in these genes are responsible for raising a woman's risk of breast cancer from 2 percent to 59 percent by age 50. The ovarian cancer risk increases from less than 1 percent to nearly 40 percent by age 50 for women with mutations in these genes.
Myriad maintained, and Aetna agreed, that by establishing a woman's increased risk, physicians can chart a course of increased surveillance. Depending upon the results of the test, a woman may consider prophylactic surgeries.
Hockett noted the $2,400 tests won't be available to all 23 million Aetna U.S. Healthcare enrollees, but that Aetna has devised six criteria based on family history and ethnicity to determine whether a woman is a good candidate for the testing.
"We didn't play an active role in developing the criteria," Hockett said. "However, we did examine the criteria and it appears to be appropriate for identifying women who could benefit from the testing."
Myriad introduced the breast cancer test in October 1996 only to find very little acceptance for the product. Since its introduction, the number of tests given has grown by 25 to 30 percent per quarter, but they still are fairly uncommon.
Matt Murray, an analyst with Lehman Bros., in New York, said two considerations in deciding to undergo testing are whether it is reimbursed by the insurance company and whether the patient's physician is familiar with the test. In his mind, the Aetna deal alleviates the first constraint.
"What you are seeing is an increasing ability for a physician to have the freedom to order the test," Murray said. "Aetna will provide general guidelines to their physicians, but clearly there is no overriding consensus about when to take the test."
However, Murray noted recent reports of the ability of the drug tamoxifen to prevent the development of breast cancer may herald the beginning of treating a patient with a specific medication based on their genetic make-up. He said Myriad is one of the first companies to be involved with the field of pharmacogenomics.
"This Aetna deal validates in our mind the clinical utility of the test and its acceptance with in the medical community," Hockett said.
Myriad disclosed the Aetna deal Monday. The company's stock (NASDAQ:MYGN) closed Tuesday at $12, down $1. *