Invitae Launches Direct-to-Consumer Pricing

By Allison Proffitt

June 1, 2015 | Invitae Corporation today announced a patient pay price for its full menu of genetic tests. For $475 per indication, patients can pay for their own genetic tests if insurance coverage is not available. The price covers all of Invitae’s offerings in cancer, cardiology, neurology, pediatric genetics, hematology and other rare conditions

The model does not sidestep a physician’s involvement though. Invitae has been adamant that genetic testing happen under the direction and care of a physician, stressed Invitae Chief Commercial Officer Lisa Alderson, speaking with Bio-IT World from the American Society of Clinical Oncology meeting this morning.

When ordering the test online, the clinician chooses the patient pay option, and submits the patient’s email address. An email alert notifies the patient that the test has been ordered and the patient can then complete the payment process online, paying the $475 with a credit card.

Invitae also introduced today a new price for institutional customers and third-party payers. Previously, all orders cost $1,500 per indication. Now institutions with whom Invitae has contracts and who bring Invitae in network, the price per indication is $950. For third-party payers with whom Invitae is out of network and non-contracted institutions, the price per indication remains $1,500.

The new patient pay rate represents a significant savings and could push costs onto patients. Why would an institution pay more than twice as much for the same test the patient can buy online?

Alderson points out that though the test is the same, serving a single patient is a more streamlined process than serving an institution.

“Part of the rational and our purpose in the pricing is to really shine light on the fact that there is a different cost to service different channels. In particular, a third party payer often requires a benefits investigation up front; it requires preauthorization; it requires us to provide a medical history. There’s just a lot of additional overhead and administrative burden, frankly, both on the payer as well as on Invitae. Our price structure reflects the true cost to service those various markets.”

When clinicians order online and patients pay upfront via an online transaction, the costs to Invitae are much lower, Alderson said. “We want to be able to pass on those lower price points to the market, particularly where it allows the market to open up and gain access to patients who would not otherwise be tested because they wouldn’t qualify for insurance coverage,” she added.  

For example, Invitae proposes that the new pricing program will provide an affordable test for women who previously tested negative for BRCA 1 and 2 and now want to consider testing for additional high risk genes for whom insurance may not cover a second test.

The Universal Test

Having to plan—and pay for—multiple rounds of genetic testing is a situation Invitae hopes to do away with soon. Since the company’s earliest days, co-founder and CEO Randy Scott has been promising a universal genetic test. “We want to aggregate all of the world’s genetic tests into a single assay—for less than the cost of a single assay today!” Scott told Bio-IT World in late 2012. Scott shared the same goal for Invitae’s initial public offering earlier this year, and raised $102 million on the idea of a universal test.

That’s still the goal, Alderson said, but for the past year Invitae has advanced on that target via indication-specific tests.

“We found that when there’s a very clear indication for testing…, the way in which we look at and interpret that information based on the patient’s medical history is different,” she said. “As we’re moving more and more toward the ‘Mendeliome’,—...the 4,000 Mendelian inherited disorders—the [clinical] basis for the testing is an important part that helps seed our clinical interpretation and guidance.”

Alderson said she expects the company will move further toward preventative tests later this year, starting with expanding panels for risk assessment, and working from the American College of Medical Genetics and Genomics’ list of 56 incidental findings to report.

“We very much believe in the future world of testing across thousands of conditions,” she said. “The path to march there is really an indication-based test. And then we’ll be layering in a more preventative, expanded panel for risk assessment where you’re looking at clinically actionable genes.”

Free the Data

Expanding the patient population beyond just those for whom insurance covers tests also builds Invitae’s data repositories. When patients pay for their own tests online, they are then directed to Invitae’s registration process that lets the patient consent to how their genetic data will be shared.

“We’re big proponents of sharing clinically-observed variants in public domains such as ClinVar—we have an effort that we support called Free the Data—because we believe that genetic information is much more valuable when shared, and it allows us to better understand the causes of the disease and ultimately improve patient care,” explained Alderson.

“Ultimately our goal is to bring genetic testing into mainstream medical practice; we believe strongly that ever cancer patient should be tested.”