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May 10, 2018

Geisinger's bold bet on personalized medicine: DNA sequencing for 'millions' of patients

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    Geisinger Health on Sunday announced that over the next six months it will be offer DNA sequencing to all of its patients as part of their "routine" preventive care in an effort to inform patients about potential genomic risk factors for cancer or heart disease.

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    Geisinger said it plans on making DNA sequencing a "routine screening," just like colonoscopies, cholesterol checks, and mammograms. Doctors will work with patients on responding to any genomic risk factors noted in the sequencing, Geisinger said.

    The initiative will build off of Geisinger's MyCode Community Health Initiative, which the health system launched in 2013. MyCode is a genomic initiative that aims to identify genomic variants in patients' DNA that put them at an increased risk of developing cancer or heart disease. So far, the initiative has identified such variants in more than 500 patients, or about 3% of the over 200,000 people enrolled in the program.

    'Truly anticipatory health care'

    David Feinberg, president and CEO of Geisinger, said understanding the genomic risk factors of each of the health system's patients "will be an essential part of wellness planning and health management." He added that the expanded screenings "will allow [Geisinger] to provide truly anticipatory health care instead of the responsive sick care that has long been the industry default across the nation."

    David Ledbetter, Geisinger's EVP and chief scientific officer, estimated that between 10% and 15% of Geisinger's patients could benefit from the expanded program. "Sequencing the known functional parts of the genome for our patients is becoming a clinical reality, not just as a diagnostic test for patients who present with particular symptoms, but for all patients in the communities we serve," he said.

    In the Harvard Business Review, Feinberg and Ledbetter added, "The way we look at it, that’s millions of Geisinger family members who no longer have to rely on the law of averages to forecast their health and make plans about their life and how they live it." They continued, "For these patients, precision health care reduces uncertainty and allows them to take charge. For clinicians, the technologies help us achieve, finally, what should be the true goal of medicine—keeping our patients well."

    But the health system could face challenges while rolling out the new program, according to FierceHealthcare, as payers have been hesitant to cover genomic testing in the past. As such, it is not clear who will pay Geisinger's patients' genomic tests (Modern Healthcare, 5/6; Geisinger release, 5/7; Reed, FierceHealthcare, 5/7).

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