insurance

Cigna And Aetna Do Not Cover "Angelina Effect" Cancer Testing

Cigna and Aetna have ensured that they will not be covering for the latest generation of tests.

Reuters states, “Medical researchers call it the ‘Angelina Effect’, the surge in demand for genetic testing attributable to movie star Angelina Jolie’s public crusade for more aggressive detection of hereditary breast and ovarian cancer.” This has been one of the most expensive treatments in the medical world, which requires some additional tests and checkups as well. Therefore, it is believed that some of the major insurance companies, such as Aetna or Cigna, have refused to cover the ‘Angelina effect’. These insurance companies have clearly declined to pay for the latest and expensive generation of tests, known as multi-gene panel tests.

The insurance companies claim that these latest tests are ‘unproven’ so far that might require additional medical care, which the patients would not need. The national medical officer for enterprise affordability at Cigna, David Finley, said that these latest tests would help in finding ‘unknown’ mutations. He said, “This is where there is controversy and disagreement. My problem is what do you do with that information?” However, from doctors to genetic counselors, academics, and diagnostic companies, have not agreed with the insurers’ claims. They termed it as “dangerous miscalculation”.

Despite of the fact that the experts in this field understand that multi-gene panel tests’ data might not be as useful from a diagnostic standpoint, but it would not favor the suffering patients. According to them, by refusing to cover up ‘Angelina effect’ on their plans, the insurers would be endangering their clients (patients) who might be in need to undergo from screenings or change their diets, etc., in order to get more knowledge about the risks.

A surgeon at Kaiser Permanente Hospital, Susan Kutner, said, “If we have members who are not being tested in a timely manner, we know that their risk of cancer in the long run costs us and them a lot more.” It is believed that the latest generation of tests can cost the insurance companies around $2,000 to $4,000, which would be analyzing 20 or more genes at once. Sources tell that humans have 23,000 genes; hence, the tests allow health care professionals to make DNA links to other cancer related conditions.

The major insurance companies are not in favor to cover this in their plans, as it might increase their costs and would benefit either the company or the patient. Health care professional strongly disagree and encourage the insurers to consider this in the near future.