At InformedDNA, we have a pretty good-sized group of genetic counselors, with more than 60 full-time certified genetic counselors on staff. That’s just a drop in the bucket, though, compared to the thousands of genetic counselors who will descend on Atlanta in mid-November for the 37th Annual National Society of Genetic Counselors (NSGC) Annual Education Conference.

InformedDNA has long valued our presence within the NSGC through staff involvement as volunteers, presenters and attendees at this conference. This year, we are very excited to be increasing our presence as a part of this conference. We will exhibit in booth 535 at the Georgia World Congress Center, with genetics specialists on hand to share information about how we bring expert genetics services to health systems, labs, pharma companies and health plans. We will also have representation from our staff who can highlight the benefits of working on the InformedDNA team.

I will be proudly representing InformedDNA on a plenary session expert panel exploring the arguments both for and against genetic counseling requirements before a genetic test can be done, titled “Pre-test Genetic Counseling: Yay or Nay.”

The “Yay”

InformedDNA has been working with Cigna for more than five years to support the Cigna Genetic Testing and Counseling program, which was among the first to require pre-test genetic counseling prior to certain high volume, high abuse testing. Through our telephonic clinical genetic counseling, Cigna has been able to ensure access to genetics expertise for their members, with member and provider satisfaction with the program measuring 95% or higher.

There are many reasons why health plans (payers) have chosen to pursue genetic counseling pre-test requirements, and the top of the list is not always to control costs. Ensuring the most clinically appropriate, evidence-based care is often a major cornerstone to these considerations. A few of the clinical benefits of a pre-test genetic counseling requirement include:

• Multiple high-profile cases have exhibited the risks of genetic testing ordered without the support of expert genetics specialists. Incorrect interpretation of risks can lead to unnecessary surgeries and other medical interventions. Having genetic experts involved in the process can help ensure that both patients and providers are more informed throughout the genetic testing process.
• The addition of pre-test genetic counseling by certified genetic counselors has enabled collection and analysis of important details or extended family history to ensure that the testing pursued is the most appropriate for the patient’s unique history. For example, while many providers are aware of the availability of BRCA gene testing to assess for Hereditary Breast and Ovarian Cancer Syndrome, evaluation of a full family history by a genetics expert may identify that the patient may qualify for additional less commonly known hereditary conditions. And, it assists in ensuring that the accurate documentation is in place for the patient in order to meet his/her insurance medical necessity criteria and avoid testing delays.
• A thorough understanding of the testing being pursued can help patients identify the best and most informative strategy for genetic testing. This may include involving more family members in the process and targeting testing to the individual whose test results will be most informative. This leads to informed decision making as well as a higher yield of quality information for not only the member but their extended family as well.

The “Nay”

In contrast, as larger scale panel testing is becoming the norm, population-based genetic testing on a wide scale may be inevitable. Along with this comes the argument that non-genetics healthcare providers are becoming more savvy with the technology, potentially limiting the need for trained genetics experts in the pre-test setting. Additionally, reported limitations in accessing certified genetic counselors has led factions to argue that a pre-test requirement is a barrier and not a benefit to patients who are interested in genetic testing. With InformedDNA’s flexible scheduling across time zones, 80% of referred clients are able to complete their pretest counseling appointment in fewer than 10 days from referral. And, 50% are able to complete their appointment in fewer than five days.

Stay Tuned…

We look forward to the panel discussion at NSGC’s AEC as an opportunity for collaborative review of the arguments both for and against pre-test genetic counseling requirements. We are constantly investigating, both as a company and a profession, the innovative ways in which genetic counseling and expert genetic services can grow and adapt as the rapidly changing field of genomics and personalized medicine play an increasingly important role in the healthcare space.

We hope that those of you attending the NSGC AEC can join us for this conversation. For those who won’t be attending, look for a follow up to this blog post in which I plan to summarize the panel discussion.

If you would like to schedule a visit with us during the conference, please submit the form below and we’ll get in touch shortly.

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