Originally published April 14.
By Turna Ray
Under a new agreement to offer its genomic testing service as part of Highmark Blue Shield's employer wellness programs, consumer genomics firm Navigenics will have access to millions of people under the payor's plans.
Highmark, a payor that provides health insurance to 4.8 million people in Pennsylvania and West Virginia, announced today that its employer customers will have the option to offer Navigenics' genomic testing service through their wellness programs. By offering this program, Highmark hopes to encourage people to live healthier lifestyles and take preventative action against diseases and chronic conditions.
Individuals interested in getting genetically tested can purchase the service through retail specialists at six Highmark Direct locations in Pennsylvania.
Highmark customer Pittsburgh Technical Institute is the first employer that has agreed to offer the genetic testing service under the program. Employees who choose to purchase Navigenics' test will learn how their genes contribute to the risk of getting 28 conditions and impact their responses to 12 medications.
This offering is not a covered benefit under Highmark's health plans. As mandated by federal law, under the Genetic Information Nondiscrimination Act, people's genetic data will not be shared with Highmark.
"We understand that people may be skeptical of an insurer's role in genetic testing. Highmark does not have access to any individual genetic testing results," a Highmark spokesperson told PGx Reporter. "Our goal is to help individuals understand their personal genetic makeup so that they can understand their risks and take the necessary health and wellness steps to live longer, healthier lives."
Employers that offer Navigenics' service can choose to subsidize the cost of the service. Navigenics did not provide an estimate for what the testing service might cost under various employer schemes, but when it was still marketing its service directly to consumers, the company charged $999 for its full testing service and $499 for a pared-down version.
In recent years, as state health regulators and the US Food and Drug Administration have begun clamping down on genomics companies marketing their services DTC, Navigenics moved away from this model and began shifting its focus to doctors' groups and employer wellness programs. Navigenics offers its service through a physicians' network, MDVIP. Doctors who are in the MDVIP network, which focuses on delivering personalized healthcare, can choose to incorporate Navigenics' DNA analysis services as part of patients' annual physicals (PGx Reporter 02/04/2009).
More recently, several employers, such as Cisco, Intel, Scripps, and several other West Coast health and technology companies have offered Navigenics' service as part of their corporate wellness programs. Separately, other California-based firms, including Scripps, Life Technologies, the energy firm Sempra, and the telecommunications company QualComm have taken part in a study conducted by the Scripps Translational Science Institute investigating whether genomic analysis provided by Navigenics inspired people to change their behavior and make healthier lifestyle choices.
The results of that clinical trial, published by Scripps Translational Science Institute researchers in the New England Journal of Medicine, showed that information about people's genetic predisposition to various diseases did not lead them to change their diet, exercise more, or use screening tests. However, the study did show that a proportion of people who shared their genetic test results with their doctors did make changes to their diet or lifestyle (PGx Reporter 01/12/2011).
Navigenics and Highmark's collaboration is founded on the hope that people make better lifestyle choices when they have expert help in understanding how their genes contribute to their overall health. Under the partnership, people who choose to learn their genetic data through Navigenics will first receive genetic counseling through the company so they can understand how to interpret the data. Navigenics counselors can help facilitate discussions between people and their personal physicians.
Simultaneously, people who choose to get genetically tested will also have access to Highmark's wellness resources, such as lifestyle coaches, preventative screenings, and nutrition programs.
"The help of a doctor, a genetic counselor, and a health coach is really going to maximize [people's] probability that they can use this information productively, as opposed to an individual who has no help or resources to act on this information," Navigenics CEO Vance Vanier told PGx Reporter.
Some critics of consumer genomics services have asserted that they are primarily a fun activity for the rich and lack any meaningful health impact. According to Vanier, however, the company's partnership with Highmark will transform its service "from a theoretical and intellectual curiosity to something that is actionable and real for [patients'] health."
Furthermore, ongoing healthcare reform efforts in the US are leading payors to increasingly focus on providing preventative services, and the potential of genomic data to inspire behavioral changes that could potentially thwart or manage chronic conditions is in line with this focus.
"If you look at what is facing health plans right now given healthcare reform, payors are looking at how they can evolve from being simply payors of care to [entities] that can create health solutions for their members, through prevention programs," Vanier said. "Highmark is the first example of how Navigenics can partner with these health plans to usher in a new era of these very powerful wellness programs."
A Highmark spokesperson said that it has conducted formal and informal market research that indicates that employers are interested in offering Navigenics' service as part of wellness programs. In order to raise awareness of this offering, Highmark's sales team is currently contacting select group customers.
This partnership with Highmark, while a first, will not be the only partnership Navigenics inks with the payor community. "We will, later this year, announce other payor partnerships," Vanier said. "If you look at the evolution of our business model, it is about how we can make wellness programs for health plans even more successful."
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