Medicare slashes payment for BRCA test

BMJ 2013; 347 doi: (Published 31 December 2013) Cite this as: BMJ 2013;347:f7709
  1. Michael McCarthy
  1. 1Seattle

Medicare, the US health insurance plan for elderly and disabled people, will halve its maximum reimbursement for the BRCA1 and BRCA2 breast cancer gene tests to $1440, down from the maximum of $2795 it paid in 2013, the US Centers for Medicare and Medicaid Services announced Friday 27 December.

The decision came after the US Supreme Court ruled unanimously last June that naturally occurring DNA segments could not be patented.1 That case involved a challenge to the patent claims of Myriad Genetics, a company based in Salt Lake City, Utah, that held patents on the BRCA1 and BRCA2 genes and used those patents to prevent competitors from producing tests that might challenge its lucrative screening business.

The court found that although the company had discovered the location and genetic sequence of the BRCA1 and BRCA2 genes, it had not created something new that warranted patent protection.

Since the court’s ruling, several companies have begun offering their own BRCA1 and BRCA2 tests at prices ranging from $900 to $2900, said the Centers for Medicare and Medicaid Services.

The centers’ reimbursement maximum will go into effect 1 January. However, the agency is accepting comments on the new pricing rule through 27 January 2014. Should those comments lead to a change in prices, those prices will go into effect 1 April 2014.


Cite this as: BMJ 2013;347:f7709