German insurance company offers genetic test

A German health insurance company is offering a free test for a genetic blood condition to its two million customers, the British Medical Journal reports. The Kaufmannische Krankenkasse (KKH) has paid for 4000 of its clients to have tests for haemochromatosis, a condition in which the body stores too much iron. The results, which showed that 67 people carried genetic mutations associated with the disorder, were given to the customers but not disclosed to the company.

Haemochromatosis is a genetic disorder that causes the body to absorb too much iron from the diet. Symptoms can include chronic fatigue, liver damage, diabetes, abdominal pain, heart problems, joint pain and 'bronzing' of the skin. It can be treated by regular removal of blood, a procedure known as venesection therapy, and patients are also advised to avoid too much iron in their diets. Haemochromatosis is caused by an inherited genetic mutation. People who inherit two copies of this mutation are at risk of iron overload, while those who inherit just one copy are healthy carriers of the condition.

Haemochromatosis can be diagnosed by measuring the iron levels in the blood, and confirmed with a genetic test. A genetic test can also identify people who may be at risk of storing excess iron, but do not yet have any symptoms. However, not everyone who inherits two mutated genes will develop the disease, so some of the 67 people identified as 'at risk' by KKH will remain healthy. But company chairman Ingo Kailuweit said that identifying patients at risk of the disorder at an early stage might prevent the need for dialysis or liver or kidney transplants later.

For KKH, who carried out the tests with the help of scientists at the Hanover Medical School, the policy makes good financial sense. The cost of treating someone diagnosed with advanced haemochromatosis is about 100,000 Euros, according to a company spokesman, while the cost of a genetic test is just 14 Euros per person. Although 4000 of its customers took up the offer, a further 2000 declined.

The German government is currently drafting new legislation on genetic testing and insurance, which will state that customers will not have to reveal genetic tests results if they are taking out life insurance policies worth less that €250,000 . It will also state that people will never have to disclose genetic tests results to employers. The new law is expected to be passed in 2006, although an industry moratorium on the use of genetic test results is currently in place, which will not expire until 2011.