Navigenics Founder Blasts Myriad's BRACAnalysis Pricing

On the heels of Angelina Jolie's revelation that she underwent a preventive double mastectomy, a Navigenics founder is taking aim at Myriad Genetics' price for its BRACAnalysis test.

In an op-ed piece appearing in the New York Times, David Agus also calls for legislative changes to bar healthcare companies from having monopolies on technologies that have life and death implications.

In addition to being one of the founders of consumer genetics testing firm Navigenics, which is now part of Life Technologies, Agus is a professor of medicine and engineering at the University of Southern California.

In his op-ed, Agus compares the nearly $4,000 charged by Myriad for BRACAnalysis to other tests and procedures — including the sequencing of a person's genes for about $1,000; 23andMe's $99 test, which can detect a variety of diseases such as Tay-Sachs, cystic fibrosis, and sickle cell; and DNA tests for human papillomavirus that cost less than $100 — and says that the reason for BRACAnalysis' high price is that there's nothing to stop Myriad from charging as it pleases.

While Myriad says that the average patient who has health insurance pays about $100 or less out of pocket for the BRCA test, Agus points out that, ultimately, consumers pay for the high cost of BRACAnalysis in the form of higher insurance premiums, co-payments, deductibles, and taxes.

"I'm all for innovation and the right to protect intellectual property, but when there is a clear monopoly and human lives are at stake, we need legislative action for rational and appropriate pricing," Agus argues. "We don’t make vaccines prohibitively expensive so only the rich can protect themselves. Nor should we let other preventive measures that can save thousands of lives be priced at levels far above what normal 'market conditions' would suggest."

He highlights an idea from Dana Goldman, a health economist at USC, to allow technologies to be licensed and made available to the masses. Under such a model, Agus says, an insurance company can pay for the IP around a diagnostic test, buy a license "on behalf of customers (you and me), and then make sure as many at-risk individuals as possible were tested."

Myriad's patents around the BRCA genes are the subject of a lawsuit filed in 2009 by the American Civil Liberties Union and others, as GenomeWeb Daily News reported at the time. The US Supreme Court last month heard oral arguments for the case and is expected to render a decision in late June.

'Play Defense with the Facts'

Like other tests that delve into medical history, personal genome scans like those from 23andMe can reveal unexpected news. Slate tells the story of "Jackie" and her brother "Alex." (Slate changed their names.) Jackie, who works in a biomedical research lab, decided to get the 23andMe scan to learn about her disease risk, but she also found out that Alex, who also was tested, was her half-brother, and the man she thought was her father was not.

Previously, doctors could determine such instances of nonpaternity — the exact rate of which is unknown, but Slate says is thought to be about 2 percent or 3 percent for overall population — through blood type testing.

Such information can now, though, be gained through not only blood typing or more focused, specific paternity tests, but through other not-so-specific tests that people might be pursuing for other reasons.

23andMe, Slate notes, has two layers of consent to go through before it will show familial relationships. "This quirky system shows the difficulties that arise in managing genomic data," Slate adds. "It used to be that people chose to learn about themselves or not, and doctors helped determine which bits of information were appropriate for each of us to know. Now we're heading for a place where secrets flow more freely, where wise consumers must play defense with the facts."

Oversight

Leroy Hood, the head of the Institute for Systems Biology in Seattle, violated a conflict of interest rule when he reviewed a friend's California Institute for Regenerative Medicine grant application, the Nature News Blog reports. Hood and the applicant, Stanford University's Irv Weissman, own vacation property together.

CIRM disclosed the conflict in a letter to the California legislature leadership, the California Stem Cell Report blog adds. The letter notes that Hood had not previously been part of the agency's grant review process and was not aware of its conflict policy regarding personal relationships. CIRM adds that Hood "agreed that there was a conflict of interest that he had overlooked."

The grant, a $24 million proposal for a genomics data center and research projects, was not funded, the Nature News Blog adds.

This, CIRM spokesman Kevin McCormack tells the California Stem Cell Report blog was "clearly a case of a new reviewer making an innocent error."

Federal Funds Boost Science, FASEB Argues

The Federation of American Societies for Experimental Biology, the advocacy group that has been working hard to press the US Congress to maintain funding at the National Institutes of Health and National Science Foundation, has issued a new fact-sheet to highlight its case that federally funded support biomedical research is necessary.

Improved health, new technology innovations and industries, and a stronger economy are among the benefits that spring from federally funded science, and in particular from the kinds of basic research that the private sector depends on but is unlikely to conduct on its own, FASEB says.

Because of the uncertain and risky nature of basic research, FASEB says, and because the time-frame for basic science projects can, in some cases, be measured in decades, the private sector is far less likely to take the risk of long-term science efforts like the Human Genome Project.

NIH and NSF also are the foundations of US science culture, FASEB argues. They support the training of new generations of researchers, fund the awards that graduate students and postdocs use to start their careers, and enable investigators to pursue high-risk, high-reward projects.

This Week in Cell

A systems biology-based analysis of postmortem brain samples from individuals with late-onset Alzheimer's disease suggests a microglial cell and immune function-related network may contribute to the disease. In Cell, researchers from the US, Iceland, and elsewhere looked at gene expression patterns in 1,647 postmortem brain samples from 549 genotyped individuals, including 376 individuals with late-onset Alzheimer's disease and 173 dementia-free control individuals. A subsequent network analysis drew the team's attention to a module with ties to immune function and the action of brain cells called microglia as well as a gene that appears to help regulate this network.

GenomeWeb Daily News has more on the study, here.

Researchers from the US, Italy, and Israel present a punctuated evolution mutation model for prostate cancer in another Cell paper. That team performed genome sequencing on matched tumor and normal samples from nearly 60 men with prostate cancer, using the data to model — and retrace the history — of genomic rearrangements in the tumors. The patterns they saw hinted that inter-dependent translocations and deletions can arise through a rush of rearrangement that study authors dubbed 'chromoplexy.' "Our modeling suggests that chromoplexy may induce considerable genomic derangement over relatively few events in prostate cancer and other neoplasms," study authors write, "supporting a model of punctuated cancer evolution."

Check out GWDN for more on the study, too.

Finally, Harvard Medical School and Children's Hospital Boston researcher Peter Park and his collaborators from the US, China, and Korea report on a catalog of somatic structural variations in cancer genomes from 10 cancer types. The group came up with the collection using genome sequence data for tumor-normal samples from 140 individuals with cancer, and an algorithm that unearths structural variants from short read sequence data. With this information, the researchers then delved into the mechanisms behind the alterations, such as double-stranded DNA breaks and errors arising during DNA replication.

Blunt Cuts

Science is moving faster than ever, but support for that research "is under greater threat than it has ever been" because of the sequester, said Francis Collins, the director of the National Institutes of Health, on Hardball with Chris Matthews last week. In the segment below, Collins also noted that the US spends about $200 billion to care for people with dementia, but only $500 million on dementia research — and that is now being cut 5 percent by the sequester.

However, Collins said his greatest worry is how such spending cuts will affect young scientists. "They are looking at this landscape in the United States and going, 'Well, maybe there's not a career here for me,'" he said. Those researchers, he said, may find another career or move to another country with better research support.

HT: DrugMonkey

Basic Building Blocks

Synthetic Genomics and ExxonMobil teamed up a few years ago to develop biofuels from algae in the hopes of fueling cars and planes. But as MIT's Technology Review points out, things don't appear to have gone as planned. Bloomberg has reported that the project "hit a snag in 2011 when a strain that made enough oil in a California greenhouse to meet a required milestone in the contract failed to perform in a pond at an ExxonMobil facility in Texas."

The companies have a new agreement, as GenomeWeb Daily News reported last week. This new agreement, Tech Review notes, gets back to basics. "[Synthetic Genomics] will focus now on its namesake technology – synthetic genomics, a relatively new science that involves making large changes to genomes, even to the point of building whole new ones," Kevin Bullis writes at Tech Review. "The goal remains the same: 'to develop strains [of algae that] reproduce quickly, produce a high proportion of lipids and effectively withstand environmental and operational conditions.'"

Into the 'Henhouse'

Three researchers at New York University School of Medicine have been charged with taking bribes in exchange for sharing private details about their work with a Chinese medical imaging company and research institute supported by the Chinese government, the New York Times reports.

The Times writes that after the US National Institutes of Health awarded a grant to Yudong Zhu, an associate professor of radiology at the school, to support his MRI technology research, Zhu recruited Xing Yang and Ye Li as research engineers. However, they also received tuition, rent, and other financial support from an executive at a Chinese imaging company who is also associated with the government-supported institute there, the Times notes.

Zhu has also been charged with falsifying records.

It's "a case of inviting and paying for foxes in the henhouse," the federal prosecutor says.

The Associated Press adds that an internal review at NYU uncovered the issue, and that Li told NYU administrators that he received thousands of dollars from the Chinese institute for work on an MRI project. According to prosecutors, Zhu also admitted receiving about $500,000, the Times says.

Zhu and Yang have been released on bond, while Li is thought to have left the country, the Times reports.

This Week in PNAS

In a study slated to appear in the early, online edition of the Proceedings of the National Academy of Sciences this week, an Ohio State University-led team assessed the expression of hundreds of microRNAs in ovarian cancer tumors, looking for those with expression profiles that coincided with chemotherapy resistance. Through an array-based analysis of almost 700 microRNAs in tumor samples from 86 women with ovarian cancer, researchers tracked down a 23-miRNA signature for chemoresistance. And their quantitative real-time PCR follow-up experiments in another 112 ovarian tumors suggested that it may be possible to predict such resistance with just three of the miRNAs: miR-642, miR-217, and miR-484.

The barley powdery mildew (Blumeria graminis f. sp. hordei) pathogen genome is comprised of chunks of sequence that are particularly rich or replete in polymorphisms, according to a study by researchers from the Max Planck Institute for Plant Breeding Research. The team sequenced the genomes of two Bgh isolates from Europe, comparing each to the barley powdery mildew reference genome. The newly sequenced isolates each contained distinct combinations of sequence blocks with high or low SNP concentrations — isolate-specific mosaic genomes that point to "exceptionally large standing genetic variation in the Bgh population," study authors say. Meanwhile, their transcriptome sequencing experiments offered a look at genes used by Bgh during attempted infiltration of barley or immunocompromised Arabidopsis.

Researchers from the National Human Genome Research Institute and the Walter Reed National Military Medical Center described a Clinical Genomics Database containing multi-faceted information on more than 2,600 genes that have been linked to a clinical condition or pharmacogenetic interaction in PNAS this week. "To aid independent analysis and optimize new data incorporation, the CGD also includes all genetic conditions for which genetic knowledge may affect the selection of supportive care, informed medical decision-making, prognostic considerations, reproductive decisions, and allow avoidance of unnecessary testing, but for which specific interventions are not otherwise currently available," the group notes.

In the Face of Competition

The increasingly competitive funding atmosphere "breeds unethical behavior," writes James Hicks, a physiologist at the University of California, Irvine, in an opinion piece at The Scientist.

Hicks charts funding success rates at the US National Institutes of Health versus the number of retracted papers and says that "we have reached such a threshold: when only around 20 percent of grants are funded, the numbers of retractions skyrockets."

At his blog, Drug Monkey says the chart appears "truthy." However, "[n]obody knows if increased retraction rates over time are being observed because fraud is up or because detection is up," he says, adding that "since NIH grant success rates have likewise been plummeting as a function of Fiscal Year, the relationship is confounded."

Richard Van Noorden ‏at Spare Thoughts offers a different chart that examines NIH success rate versus retracted papers, but that divvies the data up by total retracted publications, retracted publication from the US, and retracted publication supported by NIH or the Public Health Service.

"You will see that there is little correlation between NIH success rates and retracted US publications or retracted papers with PHS support/NIH extramural support," Van Noorden writes, though he notes that there is a correlation between success rate and total retracted publications.

"[W]e probably won't find out until, say, 2015, whether squeezed NIH success rates in 2011 and 2012 led to a higher number of retracted NIH-funded or US (or even world) papers," he adds. "So maybe we'll find out that it did. I'm not holding my breath."

No Charges for Student

The case against the Florida student who was expelled and faced criminal charges over a science experiment has been dismissed, the Associated Press reports. Sixteen year-old Kiera Wilmot's experiment mixed toilet bowl cleaner and aluminum foil in a plastic water bottle, which led to a small amount of smoke and a popping noise. While Wilmot's science teachers said they did not know of the experiment, the principal at her school said she was a "good kid" who made a bad choice.

The AP adds that Wilmot must undergo a diversion program. In addition, her expulsion, which had been put on hold as the criminal case proceeded — she has been attending an alternative school — will now go before the school board.

This Week in PLOS

A California team has garnered evidence implicating the research organism Xenopus laevis (the South African clawed frog) in the presence of the frog fungal pathogen Batrachochytrium dendrobatis in California. As they reported in PLOS One, investigators surveyed more than 200 archived frog samples by real-time PCR, including 178 samples collected in Africa between 1871 and 2000 and almost two dozen more collected in California between 2001 and 2010. The group found DNA from the Bd fungus in eight samples overall, with the earliest appearing in a 1934 sample from Kenya. Three of 23 California samples also carried the fungus. "If wild Xenopus appeared in California decades ago, during the 1970s … then by strong inference and supported by the findings reported here," they write, "introduction of Bd into this geographical area could have occurred in part via Bd infected Xenopus laevis."

Mycoplasma pneumoniae may turn up in the upper respiratory tracts children who aren't suffering from respiratory tract infections, according to a study in PLOS Medicine. Researchers from Erasmus MC and elsewhere used real-time PCR to test upper respiratory tract samples from 321 children with infections and 405 children without. Some 21 percent of asymptomatic children tested positive for M. pneumoniae DNA, compared to around 16 percent of those with documented infections, suggesting that the presence of M. pneumoniae alone may not necessarily herald infection. In follow-up experiments involving 202 more children, around 56 percent carried DNA from other bacterial or viral pathogens, too, both in the respiratory tract infection and asymptomatic groups.

The University of Würzburg's Cynthia Sharma and colleagues undertook a transcriptomics-based analysis of the gastroenteritis-causing bacterial species Campylobacter jejuni — work they describe in PLOS Genetics. The team used its so-called differential RNA sequencing strategy to sequence and compare the transcriptomes of four C. jejuni isolates (three from humans and one from a chicken), applying a new method to automatically annotate transcription start sites in each. "Overall," they write, "our study provides new insights into strain-specific transcriptome organization and [small RNAs], and reveals genes that could modulate phenotypic variation among strains despite high conservation at the DNA level."

Senate Takes up NIH Funding

A US Senate hearing on the budget for the National Institutes of Health this week became a cheering session for NIH and biomedical research and a group lament over the agency's funding woes, particularly the sequester.

The Labor, Health, and Human Services Appropriations Committee hosted NIH Director Francis Collins as well as the directors of three NIH institutes, who laid out President Barack Obama's $31.3 billion proposal for NIH and delved into a number of the initiatives that NIH is fueling, but who also warned of the many risks of cutting research funding.

In Collins' estimation, any or all of the good that could come from the White House's 1.5 percent increase for next year's NIH budget will be swept aside by the sequestration, which would cut 5 percent off of the agency's appropriation, leaving it with an effective cut of $1.6 billion.

And if the sequestration should stay in place over the next decade, as it was designed to do, NIH funding would decline by $19 billion, Collins estimated.

"The consequences will be harmful to scientific progress and to American leadership in science," Collins said.

Last fiscal year, NIH funded 8,986 research project grants. This year, that number is projected to be smaller by about 700.

The impact of the sequestration is already being felt, Collins said, and he added a human face to make his point by mentioning a former student he heard from recently, MIT investigator Dina Faddah.

Faddah, he said, is "doing spectacular research into developmental biology," but she sees what is happening in biomedical research in the US and worried enough to begin considering other careers.

Faddah wrote to Collins: "Many of my role models — top scientists with amazing ideas and the potential to change the world are unable to get funding. I can't erase the fear that this is my future. This is a defining moment. My fear is that we are putting an entire generation of US scientists at risk."

Collins was not alone in bemoaning the state of NIH funding. Committee Chairman Sen. Tom Harkin (D-Iowa) pointed out that even without the sequester, NIH funding has plunged by 22 during the past decade simply by failing to keep pace with inflation.

"In other words, the purchasing power of all NIH appropriations has fallen by over one-fifth over the past decade," Harkin said. "Perhaps even more alarming, a researcher's chance of getting a grant approved by NIH will drop to just 16 percent. That is the lowest success rate in the history of NIH."

But Harkin said that he and many other senators, including some Republicans, want to see NIH's budget boosted back up this year.

Senators Barbara Mikulski (D-Md.) and Richard Shelby (R-Alaska) both said they plan to work with members on the other side of the aisle to find ways to maintain NIH funding in the face of the sequester — although no specific ideas on how that might happen were mentioned.