Illumina has signed a value-based contract with Harvard Pilgrim Health Care, a nonprofit health plan that provides insurance coverage to approximately 1.2 million people in Massachusetts, Con-necticut, New Hampshire, and Maine. The goal of the agreement is to expand patient access to and improve reimbursement of next-generation sequencing for noninvasive prenatal testing (NIPT). Many insurers currently limit NIPT coverage to pregnant women 35 years of age or older, who are classified as having high-risk pregnancies. As part of the contract with Illumina, Harvard Pilgrim bucks this trend with open market access to NIPT for average-risk pregnancies.
The partnership will also include a 2-year study in the Harvard Pilgrim population that will assess the total costs and clinical outcomes of NIPT versus traditional screening practices. “We expect this study to demonstrate the value of NIPT for average-risk pregnancies and to help accelerate the adoption and reimbursement of NIPT,” said Ammar Qadan, vice president of Global Market Access at Illumina.