NEW YORK (GenomeWeb) – Illumina has struck a deal with Harvard Pilgrim Health Care to provide noninvasive prenatal testing to women with average-risk pregnancies. The nonprofit health services company covers around 1.2 million people in Massachusetts, Connecticut, New Hampshire, and Maine.
Under the terms of the value-based contract, Harvard Pilgrim will cover NIPT for average-risk pregnancies. However, if one-year costs of testing exceed a pre-established baseline, Illumina will reimburse Harvard Pilgrim for the costs.
An Illumina spokesperson said that an independent third-party "analyzed Harvard Pilgrim's administrative claims database to help determine a baseline level of prenatal screening test utilization and costs."
That third party will also collect clinical outcome and economic data to help determine whether NIPT for average-risk pregnancies leads to improved outcomes and how it affects costs.
Some data points that will be analyzed include whether NIPT leads to fewer invasive prenatal diagnostic tests like amniocentesis as well as whether it has an impact on the proportion of babies with chromosomal abnormalities who are born at specialized hospitals. In addition, the organizations plan to analyze the impact of covering NIPT for average-risk pregnancies on total screening costs.
The goal is to "determine the real-world clinical and economic outcomes of [average-risk] NIPT and provide the data that is currently lacking for payors," the spokesperson said.
"Through this partnership with Illumina, Harvard Pilgrim is furthering its quality agenda by making this test available to pregnant women of average risk and can do so in a way that limits the extent to which this expansion might increase overall healthcare costs," Harvard Pilgrim Chief Medical Officer Michael Sherman said in a statement.
Ammar Qadan, Illumina's vice president of global market access, added, "We expect this study to demonstrate the value of NIPT for average-risk pregnancies and to help accelerate the adoption and reimbursement of NIPT."