DTC Pharmacogenetic Testing and Health Insurance: Good for Health, Good for Business?

Abstract

Increasingly, Canadian group health insurers are entering into business partnerships with pharmacogenomics companies. In this context, they may even offer partial or total coverage of a growing range of pharmacogenetic (PGx) tests. PGx testing considers how a person’s genes impact their likely response to medication. Partnerships between PGx testing companies and insurers have the potential to personalize and improve medical care, while also benefiting insurers, PGx companies, employers, and the healthcare system. Yet, these partnerships can also involve risks for consumers. This chapter outlines PGx testing and its benefits before exploring the privacy, discrimination, and health risks arising from group insurance coverage of PGx tests. It is argued that the high level of variance in consent practices across PGx testing providers and often incomplete explanations of key privacy considerations undermine the extent to which consumers’ consent to undertaking PGx testing in this context is truly informed. Moreover, consumers should be aware of the potential for genetic discrimination from PGx testing. While the likelihood of genetic discrimination is mitigated by the nature of PGx test results and the existence of genetic discrimination legislation, depending on the specific circumstances, it remains a small possibility that genetic discrimination from PGx results may come to affect consumers or their family.

Keywords: pharmacogenetics, discrimination, pharmacogenomics, PGx, insurance, privacy, consent