Blue Shield of CA First to Cover Rapid Whole-Genome Sequencing for Critically Ill Children

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Blue Shield of California announced Monday that it will cover the cost of the rapid and ultra-rapid whole-genome sequencing developed by Rady Children’s Institute for Genomic Medicine (RCIGM) to help diagnose critically ill children in intensive care with unexplained medical conditions.

The coverage decision from the private payer comes as Rady looks to expand the use of its advanced diagnostic methods that help find genetic disorders in children and to identify precision treatments for their rare conditions.

“Our system is optimized to identify or rule out most genetic diseases in a single test, and provide the medical team at the bedside with child-specific, disease-specific information so they can make better, faster medical decisions,” said Stephen Kingsmore, M.D., DSc, president and CEO of RCIGM in a press release.

Rady Children’s Hospital has been committing significant resources into expanding its program of rapid whole-genome sequencing beyond its wall over the past couple of years. It has a partnership with the Vermont Oxford Network based in Burlington, VT, to provide these services for critically ill babies; and has been working to improve the speed of delivery of samples from care teams across the country to the RCIGM’s sequencing facility including launching a pilot program with Deloitte to test delivery of samples from San Diego airport to its facility via drones.

Blue Shield members with individual and family plans or employer-sponsored health plans who have a critically ill child, up to age 18, hospitalized in neonatal or pediatric intensive care at any location with an undiagnosed condition may be eligible.

“We know that uncertainty and long testing wait times can create tremendous risks for children in intensive care, and anxiety for their families, all the while creating more challenges for physicians and specialists,” said Terry Gilliland, M.D., executive vice president of Healthcare Quality and Affordability at Blue Shield of California, in a statement. “By providing our members with access to Rady Children’s Institute for Genomic Medicine’s pioneering work in rapid whole genome sequencing, we’re supporting them in what is often the most difficult time in their lives.”

Without medical insurance coverage, access to rapid Whole Genome Sequencing is often not readily available for many hospitalized children who could potentially benefit from this service. Families in need of this care have often had to rely upon funding provided by private philanthropy and research grants to gain access to rapid Whole Genome Sequencing and associated precision care.

“Genetic disease is a leading cause of infant death in the U.S. and Blue Shield is paving the way in providing coverage for this rapid, molecular diagnosis that can result in life-saving treatments,” Kingsmore said.

Located on the campus of Rady Children’s Hospital-San Diego, the Institute houses a state-of-the-art genome sequencing lab and employs a multi-disciplinary team of experts who specialize in providing timely and accurate guidance to physicians caring for children with rare genetic disease.

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