By Allison Proffitt
June 1, 2015 | Invitae Corporation today announced a patient
pay price for its full menu of genetic tests. For $475 per indication,
patients can pay for their own genetic tests if insurance coverage is not
available. The price covers all of Invitae’s offerings in cancer, cardiology,
neurology, pediatric genetics, hematology and other rare conditions
The model does not sidestep a physician’s involvement
though. Invitae has been adamant that genetic testing happen under the
direction and care of a physician, stressed Invitae Chief Commercial Officer Lisa
Alderson, speaking with Bio-IT World from the American Society of Clinical Oncology
meeting this morning.
When ordering the test online, the clinician chooses the
patient pay option, and submits the patient’s email address. An email alert
notifies the patient that the test has been ordered and the patient can then
complete the payment process online, paying the $475 with a credit card.
Invitae also introduced today a new price for
institutional customers and third-party payers. Previously, all orders cost
$1,500 per indication. Now institutions with whom Invitae has
contracts and who bring Invitae in network, the price per indication
is $950. For third-party payers with whom Invitae is out of
network and non-contracted institutions, the price per indication remains $1,500.
The new patient pay rate represents a significant savings
and could push costs onto patients. Why would an institution pay more than
twice as much for the same test the patient can buy online?
Alderson points out that though the test is the same,
serving a single patient is a more streamlined process than serving an
institution.
“Part of the rational and our purpose in the pricing is to
really shine light on the fact that there is a different cost to service different
channels. In particular, a third party payer often requires a benefits
investigation up front; it requires preauthorization; it requires us to provide
a medical history. There’s just a lot of additional overhead and administrative
burden, frankly, both on the payer as well as on Invitae. Our price structure reflects
the true cost to service those various markets.”
When clinicians order online and patients pay upfront via an
online transaction, the costs to Invitae are much lower, Alderson said. “We
want to be able to pass on those lower price points to the market, particularly
where it allows the market to open up and gain access to patients who would not
otherwise be tested because they wouldn’t qualify for insurance coverage,” she
added.
For example, Invitae proposes that the new pricing program will
provide an affordable test for women who previously tested negative for BRCA 1
and 2 and now want to consider testing for additional high risk genes for whom
insurance may not cover a second test.
The Universal Test
Having to plan—and pay for—multiple rounds of genetic
testing is a situation Invitae hopes to do away with soon. Since the company’s
earliest days, co-founder and CEO Randy Scott has been promising a universal genetic
test. “We want to aggregate all of the world’s genetic tests into a single
assay—for less than the cost of a single assay today!” Scott told Bio-IT World in late
2012. Scott shared the same goal for Invitae’s initial public offering
earlier this year, and raised
$102 million on the idea of a universal test.
That’s still the goal, Alderson said, but for the past year
Invitae has advanced on that target via indication-specific tests.
“We found that when there’s a very clear indication for
testing…, the way in which we look at and interpret that information based on
the patient’s medical history is different,” she said. “As we’re moving more
and more toward the ‘Mendeliome’,—...the 4,000 Mendelian inherited disorders—the
[clinical] basis for the testing is an important part that helps seed our clinical
interpretation and guidance.”
Alderson said she expects the company will move further
toward preventative tests later this year, starting with expanding panels for
risk assessment, and working from the American College of Medical Genetics and
Genomics’ list of 56 incidental findings to report.
“We very much believe in the future world of testing across
thousands of conditions,” she said. “The path to march there is really an
indication-based test. And then we’ll be layering in a more preventative,
expanded panel for risk assessment where you’re looking at clinically actionable
genes.”
Free the Data
Expanding the patient population beyond just those for whom insurance
covers tests also builds Invitae’s data repositories. When patients pay for
their own tests online, they are then directed to Invitae’s registration
process that lets the patient consent to how their genetic data will be shared.
“We’re big proponents of sharing clinically-observed
variants in public domains such as ClinVar—we have an effort that we support
called Free
the Data—because we believe that genetic information is much more valuable
when shared, and it allows us to better understand the causes of the disease
and ultimately improve patient care,” explained Alderson.
“Ultimately our goal is to bring genetic testing into
mainstream medical practice; we believe strongly that ever cancer patient should
be tested.”