When Dr. Wayne Grody heard that the Supreme Court ruled Thursday that Myriad Genetics could not patent two genes linked to breast cancer, the UCLA medical geneticist was minutes from giving a well-worn speech on the years-old case to a room full of University of Oregon medical school students.
"I improvised when I got to the very end," Grody said.
The court’s 9-0 decision in the case involving the Utah-based Myriad Genetics was welcome news to Grody as well as other doctors and genetic counselors concerned about future research and genetic counselors who said they’ve had their hands tied by the company’s high prices and tough patent enforcement.
"I’m very happy," said Raluca Kurz, a certified genetic counselor with Cedars-Sinai Medical Center. "I think we’ve all been waiting for this to happen for a long time."
Roughly 80% of Cedars’ genetic testing for cancer involves the genes known as BRCA1 and BRCA2, Kurz said. Certain mutations in these genes make a woman five times more likely to develop breast cancer than those without the dangerous versions, according to the National Cancer Institute.
And yet Myriad’s BRACAnalysis test’s sticker price of $3,300 blocked many eligible women without insurance coverage from getting screened. And the price has risen incrementally over time, Kurz said -- even as the cost of running the test with older technology should have been on the decline.
"It was very disheartening and heartbreaking because we had families that couldn't afford the test," Kurz said.
The Supreme Court ruling would allow other companies to develop their own tests, introducing competition into the market, Kurz said.
"It’ll make life easier because now we can order one test or find a better price," Kurz said. "All those good things that a monopoly does away with."
Dr. Jeffrey Weitzel, director of City of Hope's cancer screening and prevention program in Duarte, agreed.
"There is a benefit to letting the collective intellectual forces of the academic world and the markets help to enhance care," he said between connecting flights to Lima, Peru, where he was set to promote BRCA gene analysis in middle-income countries.
"I think that it’s quite late given that it’s the end of the patent in the next two years, so I’m not sure it’ll make a material difference," he added. "But the principle is important."
Having multiple tests would also allow worried patients to get second opinions before using the test results to make profoundly life-altering decisions, such as getting a preventative double mastectomy, Grody said.
In terms of breast cancer screening, Grody said his practice — he directs UCLA Medical Center’s diagnostic molecular pathology lab — would not likely change: Myriad was a reliable company and its database of genetic variants built up over the years gave the company invaluable experience in differentiating between dangerous and benign mutations.
But many other, less common genes have also been covered by patents, he added, whose holders have been quick to shut down any perceived competition.
With the new decision released, Grody planned to add a host of genetic tests -- including genes for congenital hearing loss, spinocerebellar ataxia and various muscular dystrophies -- "right back on our test menu" for patients at UCLA, he said.
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