"Anthem considers these tests investigational and not medically necessary," says a spokesman for the carrier, which covers 41 million people. This skepticism is shared by some insurance companies. Shots - Health News An Experimental Genetic Test Gives Early Warning For Kids At Risk Of Type 1 Diabetes But in psychiatry, McMahon says, how fast someone processes a drug, or metabolizes it, and how well they respond to the drug "are sometimes not strongly related." Usually, the longer it takes your body to process a drug, the easier it is for that medication to have an effect. This link between genes and drug metabolism has been known for decades, says Francis McMahon, who leads genetic research into mood and anxiety disorders at the National Institutes for Mental Health. Which variant a person has can affect how quickly or slowly a medicine moves through their body. The idea behind the tests is that in some cases, people can have different reactions to the same drug, even at the same dose, because they have different gene variants. "It's just the evidence at this point is still weak." "I wouldn't say there's no evidence that it works," he says. James Potash, the head of psychiatry at Johns Hopkins Medicine and an expert on psychiatric genetics, says of all the tests claiming to improve depression treatment, GeneSight's has the most proof. But many researchers say there is not enough evidence tying genetic variants to better outcomes for most psychiatric medications. Genomind has discussed coverage with insurers including Anthem and Blue Cross Blue Shield, O'Brien says.Īs the field of genetic testing to help diagnose and treat disease grows, medicine has embraced certain tests, such as that for the BRCA gene linked to breast cancer. In addition to UnitedHealthcare's coverage, Myriad Genetics' test is covered by Medicare, a regional Blue Cross Blue Shield affiliate, and the insurance network for the grocery chain Kroger, a spokesperson says. Myriad reported that it sold $113 million worth of the tests. If the prediction is correct, it would likely fuel a market that has seen its largest test maker, Myriad Genetics, sell about 375,000 of its psychiatric medicine tests in the 2019 fiscal year, according to Jack Meehan, an industry analyst for Barclays. Other insurers will cover the tests "because they don't want to be uncompetitive in the marketplace," he predicts. "We expect this to be a tipping point," says Shawn Patrick O'Brien, CEO of Genomind, a company that makes one of the tests. Test makers hailed the announcement of United's coverage, the first from an insurance company to apply to all of its commercial plans across the country. Shots - Health News The Promises And Pitfalls Of Gene Sequencing For Newborns Nonetheless, UnitedHealthcare, the nation's largest insurer, began covering them October 1 for its 27 million individual and group plans. The Food and Drug Administration has warned that the tests could potentially steer patients towards the wrong medications. But many researchers say the tests don't have enough evidence backing them up. Psychiatric medications are known to be hard to match to symptoms, and many patients like Gruman live through years of trial and error with their doctors.Ĭompanies that make genetic tests like the one Gruman used say they can save patients and doctors from prolonged searching for the right medication and save insurance companies from paying for ineffective drugs. "I could have avoided a lot of disaster in my life," she says. She says she wishes she had taken the test as a teenager. Medications that hadn't worked for her as a teenager were the same ones the results marked as bad fits. Reading the test results "was definitely vindicating," she says. But when a clinician recommended a genetic test to see which drugs work best for her, she took it. Now 28 and in recovery, Gruman has been on the same drugs for years. It would take five years, and trying more than 15 different medications, before she found meds that actually helped. None seemed to help her manage symptoms of anxiety and bipolar disorder, so she self-medicated with alcohol and illicit drugs. Evidence that the tests are effective has been called "inconclusive."Īs a teenager, Katie Gruman was prescribed one mental health drug after another. Myriad Genetics is among a handful of companies that make a genetic test to help doctors choose psychiatric medicines for patients.
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