Life goes on

Last night Congress approved and the President signed a Senate leadership brokered compromise continuing resolution that ended the partial government shutdown (at least until January
15, 2014) and will suspend the debt ceiling until February 7, 2014. The best
summary of the bill from FEHBP standpoint is this excerpt from the Wall Street Journal

The Senate agreement includes no major alterations to the 2010 health-care law. But the deal will include one
minor change sought by Republicans, setting new procedures to verify the
incomes of some people receiving government subsidies for health-insurance
costs. Negotiators rejected a Democratic proposal to delay for one year a fee
of $63 per insured person levied on groups that offer health policies,
including employers, labor unions and insurance carriers—a fee opposed by many
large employers and unions. The agreement does includes backpay for all federal
workers who were furloughed during the government shutdown.

The Journal of Accountancy has more details on the ACA provision in the CR (as it’s a tax law provision).

Keeping going with the good news, the Wall Street Journal reports today that

New results from the Cancer Genome Atlas research project identify a host of genetic mutations that are common among 12 different types of cancer, reflecting the growing understanding that tumors can be defined by their underlying biology rather than their location in the body.

The article explains that

One of the mutations identified in the study, in a gene called BRAF, highlights both the promise and the challenge of finding what role the same mutation may play in different types of tumors.
The BRAF mutation already is implicated in more than half of cases of melanoma; in the new study, it was found in 7% of certain lung cancer tumors, 4% of colon cancer malignancies and in smaller fractions of brain, bladder, head-and-neck, kidney and ovarian cancers.  Roche Holding AG’s drug Zelboraf is approved for melanoma patients with a BRAF mutation, and in small studies it has shown promise among lung-cancer patients with the same mutation. But researchers say other studies indicated the drug used alone has little effect on BRAF-driven colon-cancer tumors.

Last spring, the U.S. Supreme Court invalidated a patent on a test for the BRAC genetic mutation.  Also last Spring, HHS determined that health plans must provide in-network coverage for the test without member cost sharing according to he ACA. Plans, however, may apply medical management techniques to ensure medical necessity for the testing. Bloomberg reported on Tuesday that

Quest Diagnostics Inc. (DGX), the biggest U.S. operator of medical labs, will sell a test for two breast cancer genes starting today [October 15], providing competition for Myriad Genetics Inc. (MYGN) and potentially helping to reduce costs for women fearful they are at risk of the disease.  Quest will sell the most comprehensive version of its test for the BRCA1 and BRCA2 genes for $2,500, said Richard Bender, a consultant for the Madison, New Jersey-based company. The price compares with almost $3,400 that Medicare pays for the most comprehensive version of a test from Myriad. About 85 percent of the Salt Lake City-based company’s $613.2 million in revenue came from BRCA testing in the fiscal year ended June 30. * * * Mutations in the BRCA1 and BRCA2 genes, the most common cause of hereditary breast and ovarian cancer, are present in roughly 1 in 400 women and give women an elevated risk of ovarian cancer as well as a higher breast cancer risk.

The article adds that Myriad is continuing its litigation to challenge competitor’s alleged use of Myriad patents that were not affected by the Supreme Court decision (a complicated legal issue). Quest brought a preemptive declaratory judgment action against Myriad in federal court to challenge this strategy.  

One comment on “Life goes on

  1. I would highly recommend the BRAC-1 and BRAC-2 gene testing for any woman who might be at risk for, or who has had breast cancer.

    My wife is a bi-lateral breast cancer survivor. And while technically she was in remission for this disease, there was always an underlying worry that she was hyper-prone to a re-occurrence. The BRAC 1&2 gene tests allayed her fears by confirming that she did not carry the gene mutation. That level of peace-of-mind was worth far more than the cost of this test.

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