US cancer patients with private insurance have little to no out-of-pocket costs for genetic counseling, according to data published in JAMA Health Forum

In a cohort of nearly 17,000 patients, the median out-of-pocket cost for genetic counseling was $0. 

Researchers used the IBM Watson Health MarketScan, an administrative claims database, to collect data on privately insured cancer patients who had at least 1 encounter for genetic counseling between January 2013 and December 2019. 

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Most patients had breast cancer (n=12,722), followed by colorectal cancer (n=1417), ovarian cancer (n=1312), endometrial cancer (n=622), prostate cancer (n=356), and pancreatic cancer (n=312). All included cancer types had National Comprehensive Cancer Network guidelines for genetic or familial high-risk assessment. 

The median net payment for genetic counseling encounters was $118 (interquartile range [IQR], $58-$211). However, most patients paid $0 for genetic counseling services. 

The median out-of-pocket cost was $0 (IQR, $0-$16), and less than one-third (31.1%) of patients had an out-of-pocket cost that was greater than $0. 

Patients with prostate cancer were more likely to have out-of-pocket costs when compared with patients who had breast cancer (adjusted prevalence ratio, 1.28; 95% CI, 1.04-1.57). Patients with the other cancer types were less likely than breast cancer patients to pay out of pocket for genetic counseling.

“The findings highlight the relatively low financial costs of genetic counseling, a form of care with potentially substantial implications for cancer treatment,” the researchers concluded.

Disclosures: One study author is employed by Concert Genetics. Please see the original reference for full details.


Roberson ML, Padi-Adjirackor NA, Hooker G, Pal T. Evaluating costs associated with genetic counseling among commercially insured US patients with cancer from 2013 to 2019. JAMA Health Forum. Published online July 29, 2022. doi:10.1001/jamahealthforum.2022.2260.