Pharmacogenomic Testing For The Insurance Industry

Genetic testing, similar to other interventions in healthcare that aims to improve patient outcomes while reducing cost of care, is increasingly adopted by the insurance industry. In general, most plans cover genetic testing that is proven to help choose the best course of a certain medical condition.

In particular, genetic testing for drugs metabolism or response is called pharmacogenomic (or pharmacogenetic) testing. Pharmacogenomic testing is different from tumor genetic testing, because it identifies genetic variations in the human, rather than the cancer. This means that pharmacogenomic testing can also help optimize safety and efficacy of medications in cardiology, psychiatry, and many other critical or chronic conditions beyond cancer.

The value of pharmacogenomic testing for the insurance industry has been apparent by the increasing coverage of testing in numerous policies and programs in the US and Asia.1,2,3 But even in developed markets, the review process has been varied. Often, they consider key factors such as the number of genes, the size of scope, and target population defined in the policy plan.