3 ms·

This sounds like something insurance will either refuse to cover for being expensive or make you try 5 other approaches first before agreeing to cover it, at wh

This sounds like something insurance will either refuse to cover for being expensive or make you try 5 other approaches first before agreeing to cover it, at which point it'll probably be too late.

throwaway894345 5y ago
To the extent this is true today, I suspect it's precisely because the precision medicine approach is not yet the standard. I.e., insurance companies want you to do the standard of care, but if/when precision medicine _becomes_ the standard then insurance companies will embrace it (or that's my hypothesis, anyway).
xwdv 5y ago
This is partly why it’s important to save for retirement so you can be well capitalized to fund such treatments on your own if they should become necessary.
pilotneko 5y ago
Small consolation, but I believe GINA should prevent that behavior. https://www.hhs.gov/hipaa/for-professionals/special-topics/genetic-information/index.html https://www.hhs.gov/hipaa/for-professionals/special-topics/g...
sjg007 5y ago
Unlikely. It will rule out treatments that are unlikely to work, saving money. What we are seeing is Simpson’s paradox. Genomics and precision medicine allow you to segment populations at a higher resolution then before.
- riboflavin123 5y ago
  It may rule them out. But many standard-of-care chemo drugs are quite cheap. When I had leukemia, my first rounds of chemo used cheap drugs. (The drugs were far cheaper than the daily hospitalization costs, which was required due to drugs obliterating the immune system.) The insurance company didn't require any oversight into the process. But once the chemo stopped working and a much more expensive treatment was needed, the insurance company became quite a pest. I'm fortunate have saved a lot of money, so I didn't delay treatment until insurance approved it. (The 2-3 weeks between treatment starting and the final approval from insurance may have actually made a difference between life-and-death when dealing with aggressive leukemia.)
  - sjg007 5y ago
    I’m glad you’re here and a survivor of that hell. Yes, what you are describing is a very real problem. It’s something we need congressional action on. Call it a surprise medical bill but more rather a surprise insurance denial. I am no stranger to insurance battles… I actually should have put it differently. Precision medicine will bring new treatments to the standard of care because we will be able to find the correct drug for you or me.
- jghn 5y ago
  Exactly. Insurance companies are very interested in Real World Data (RWD) around genomic based treatments. By using those data they can have a better sense of which patients would be likely to respond to which drugs, and steer treatment that way.
  - Gibbon1 5y ago
    There another reason for genomic tests they also rule out the need for treatment. Either the tumor is benign or very low grade cancer.
chefkoch 5y ago
How much will a bit of sequencing and CPU time cost? 5k what genomic sequencing for other cancers cost is peanuts in cancer care. There are many drugs where one infusion (of many needed) is more expensive than that.

This sounds like something insurance will either refuse to cover for being expensive or make you try 5 other approaches first before agreeing to cover it, at which point it'll probably be too late.

throwaway894345 5y ago

To the extent this is true today, I suspect it's precisely because the precision medicine approach is not yet the standard. I.e., insurance companies want you to do the standard of care, but if/when precision medicine _becomes_ the standard then insurance companies will embrace it (or that's my hypothesis, anyway).

xwdv 5y ago

This is partly why it’s important to save for retirement so you can be well capitalized to fund such treatments on your own if they should become necessary.

pilotneko 5y ago

Small consolation, but I believe GINA should prevent that behavior. https://www.hhs.gov/hipaa/for-professionals/special-topics/genetic-information/index.html https://www.hhs.gov/hipaa/for-professionals/special-topics/g...

sjg007 5y ago

Unlikely. It will rule out treatments that are unlikely to work, saving money. What we are seeing is Simpson’s paradox. Genomics and precision medicine allow you to segment populations at a higher resolution then before.

riboflavin123 5y ago
It may rule them out. But many standard-of-care chemo drugs are quite cheap. When I had leukemia, my first rounds of chemo used cheap drugs. (The drugs were far cheaper than the daily hospitalization costs, which was required due to drugs obliterating the immune system.) The insurance company didn't require any oversight into the process. But once the chemo stopped working and a much more expensive treatment was needed, the insurance company became quite a pest. I'm fortunate have saved a lot of money, so I didn't delay treatment until insurance approved it. (The 2-3 weeks between treatment starting and the final approval from insurance may have actually made a difference between life-and-death when dealing with aggressive leukemia.)
- sjg007 5y ago
  I’m glad you’re here and a survivor of that hell. Yes, what you are describing is a very real problem. It’s something we need congressional action on. Call it a surprise medical bill but more rather a surprise insurance denial. I am no stranger to insurance battles… I actually should have put it differently. Precision medicine will bring new treatments to the standard of care because we will be able to find the correct drug for you or me.
jghn 5y ago
Exactly. Insurance companies are very interested in Real World Data (RWD) around genomic based treatments. By using those data they can have a better sense of which patients would be likely to respond to which drugs, and steer treatment that way.
- Gibbon1 5y ago
  There another reason for genomic tests they also rule out the need for treatment. Either the tumor is benign or very low grade cancer.

chefkoch 5y ago

How much will a bit of sequencing and CPU time cost? 5k what genomic sequencing for other cancers cost is peanuts in cancer care. There are many drugs where one infusion (of many needed) is more expensive than that.