ST. PETERSBURG, Fla., Nov. 23, 2015 /PRNewswire/ -- Cigna (NYSE: CI) has published a new coverage policy on whole exome sequencing (WES) and whole genome sequencing (WGS) in collaboration with InformedDNA, the nation's largest network of independent genetics experts. This marks the first time a national health plan has defined coverage criteria for WES, a complex genetic test that analyzes all of the genes and their coding sections called exons – together called the "exome."
Recent advancements in sequencing technology have made WES possible. Requests for WES have been growing by 10 percent per quarter; however, until now, health plans either did not cover WES at all or approved it only on a case-by-case basis.
While the exome makes up about one percent of the genome and is the component most likely to have identifiable mutations that are linked to clinical conditions, it does not provide answers in a majority of complex cases, and often uncovers variants of unknown significance that can raise troubling concerns among individuals and their healthcare providers.
In 2012, the American College of Medical Genetics (ACMG) published a policy statement offering guidelines for ordering WES, including a recommendation for pre- and post-test consultation with a genetics professional. However, the guidelines did not provide specific testing criteria. As a result, it hasn't been clear to healthcare providers when WES is considered a useful diagnostic test that health plans will cover.
Cigna's policy establishes appropriate clinical structure that may help guide healthcare providers when they consider ordering whole exome sequencing.
"Not all genetic tests have clinical value, nor are they appropriate for the entire population, just like a new medication wouldn't be right for everybody," said Jeffrey F. Hankoff, M.D., Cigna's medical officer for clinical performance and quality. "This coverage policy provides the clarity that healthcare professionals need and will help them and their patients make informed decisions to drive improved clinical outcomes."
Cigna's new coverage policy acknowledges and further clarifies ACMG's original guidelines, and addresses the concerns of healthcare providers. It should help guide health care professionals to make more informed decisions regarding when testing should be offered in consultation with a genetics professional and when WES results will help aid clinical decision making or clinical outcomes.
This isn't the first collaboration between InformedDNA and Cigna. The two companies have an ongoing arrangement which leverages the genetics expertise of InformedDNA to help individuals and healthcare providers make appropriate use of genetic testing. This innovative approach has helped keep both companies on the leading edge of the rapidly expanding field of genetic testing.
About InformedDNA: InformedDNA helps individuals and healthcare providers accurately interpret family health history and genetics, bringing the promise of personalized healthcare to life. InformedDNA is the authority on the appropriate use of genetic testing – leveraging the expertise of the largest network of independent board-certified genetics specialists to help ensure health plans, hospitals, employers, community clinicians and patients all have access to the highest quality genetic services. InformedDNA's key offerings include clinical genetic counseling, genetic testing utilization management, and personalized hereditary risk assessment and prevention solutions. For more information, visit InformedDNA.com.
About Cigna: Cigna Corporation (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. All products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, Life Insurance Company of North America and Cigna Life Insurance Company of New York. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products including group life, accident and disability insurance. Cigna maintains sales capability in 30 countries and jurisdictions, and has more than 89 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.