Patients over Patents: AMP and ASHG Reaffirm that Genes Should Not be Patentable

Guest Post By: Mary Steele Williams, MNA, MT(ASCP)SM, Executive Director of Association for Molecular Pathology

Earlier this summer, the Association for Molecular Pathology (AMP) spearheaded a sign-on letter with the American Civil Liberties Union (ACLU), ASHG, and a diverse community of approximately 200 medical, scientific, patient advocacy, women’s health, and civil rights organizations.

Mary Steele Williams, Executive Director of Association for Molecular Pathology (AMP), and Dr. Roger Klein, MD, JD, AMP leader, outside the Supreme Court Building, Washington, D.C., during AMP v. Myriad in 2013.” (Provided by AMP)
Mary Steele Williams, Executive Director of Association for Molecular Pathology (AMP), and Dr. Roger Klein, MD, JD, AMP leader, outside the Supreme Court Building, Washington, D.C., during AMP v. Myriad in 2013. (Provided by AMP)

The letter expressed serious concerns with the recent draft proposal to amend Section 101 of the Patent Act, and warned about the significant consequences of allowing DNA and gene-disease associations to be patentable. ASHG and ACMG past and current leadership also sent out a letter to the bill’s sponsors expressing similar concerns. This month, ASHG caught up with Mary Steele Williams, Executive Director of AMP to discuss the history of gene patents and the current legislation.

ASHG: What would it mean for the genetics community if genes could be patented?

Ms. Williams: This proposal would have massive reverberations across all sectors of the genetics community. If naturally-occurring DNA sequences, segments or gene-disease associations become patent-eligible again, there would be serious consequences for research and clinical diagnostics. Legislation that allows the patenting of natural phenomena, laws of nature or abstract ideas would impede innovation by hampering discovery and the development of new technologies – because these aspects of nature cannot be designed or invented around. The clinical application of genetic research, diagnostic tests, and clinical services would be stymied. For example, multi-gene sequencing panels could require licensing arrangements for each gene or gene variant, which would significantly drive up costs for patient care. Even worse, testing could become unavailable altogether if owners refused to license at reasonable (or any) terms.

ASHG: What would it mean for the general public?

Ms. Williams: Patient care would become stifled, as we would return to the days when the basics of nature, our genes, and the mental processes of gene-disease association could be privately owned and restricted in access. Patent holders could choose whether a diagnostic test could be developed and by whom, and even influence its overall design. This could result in a test being offered by a single entity, an outdated version of a test being the only one available, or not being available at all. This was increasingly the norm prior to the 2013 Association for Molecular Pathology v Myriad Genetics ruling. Because gene sequences are not patent-eligible, a lot of amazing research and progress in clinical care is able to evolve and thrive, and it is critical that we protect this innovation.

ASHG: Tell us about the 2013 AMP v. Myriad ruling and its effects.

Ms. Williams: For over 150 years, the Supreme Court has held that laws of nature, natural phenomena, and abstract ideas are not patent-eligible under Section 101 of the Patent Act. In the landmark 2013 AMP v. Myriad  case, a unanimous Supreme Court ruled in favor of the plaintiffs (AMP, et al.) and determined that a “naturally occurring DNA segment is a product of nature and not patent-eligible merely because it has been isolated.” The Court concluded that such patents would lock up genetic information and prevent others from scientific and medical work.

The Court’s 2013 ruling was the culmination of many years of deep concern within the medical field, and was celebrated across the greater scientific community who fought hard for the chance to be heard. The positive impact was immediate, and molecular testing is now part of the standard of care. On the day of the AMP v. Myriad decision, five laboratories announced their intention to develop BRCA1/2 tests. Since then, the clinical use of genetic tests and genetic research has continued to thrive. We are now approaching 10,000 multi-gene panel tests on the market with an average of 14 new molecular tests added each day.

ASHG: Why and how has this issue re-emerged?

Ms. Williams: Earlier this year, following a series of closed roundtable discussions, Senators Tillis (R-NC) and Coons (D-DE) and Representatives Collins (R-GA), Johnson (D-GA), and Stivers (R-OH) released draft legislation that proposed to radically alter Section 101 of the Patent Act. The draft language would shift the focus of Section 101 to favor those seeking patents by allowing patents on anything found to be useful. It explicitly indicates  that judicially-created exceptions for abstract ideas, laws of nature, or natural phenomena cannot be used to determine patent eligibility. Essentially, the draft proposes to abrogate all court decisions that led to or supported those exceptions, including Mayo Collaborative Servs. v. Prometheus (2012), AMP v. Myriad (2013), and Alice Corp. v. CLS Bank (2014).

ASHG: What is AMP doing in response?

Ms. Williams: Since the draft was released, the sponsors of the legislation have stated that it was not their intent to allow patenting of “DNA within the human body.” However, this argument does not alleviate AMP’s concerns. The AMP v. Myriad decision was so important because it specifically determined that naturally occurring DNA sequences or segments are products of nature, and are not patent-eligible merely because they had been isolated.

AMP remains very concerned about the actual impact the draft legislation would have and the consequences of this evolving proposal, regardless of stated intent. The potential effects this legislation could have on research and patient care would be enormous and damaging. AMP anticipates that the next draft of the legislative proposal will be released sometime in the next few months. In the meantime, AMP continues to work diligently with aligned stakeholders, including ASHG, to lead efforts to educate others about this issue and advocate for naturally-occurring DNA sequences or segments and gene-disease associations to remain patent-ineligible.

Today, AMP is prepared to win this fight again. In this age of precision medicine, it is more important than ever to maintain the boundaries between nature and technology, so that we can continue to develop innovative diagnostics for devastating diseases and provide access to the best medical care. Since the Supreme Court’s 2013 decision, multiplex gene panels that feature dozens of genes in a single test are now routine practice. Advances such as this would have been difficult, if not impossible, without the Court’s decision. We must keep the focus on patients.

To stay up-to-date on this issue and more, be sure to subscribe to ASHG’s monthly policy and advocacy email updates.

Take Action this August Recess: Meet Your Elected Officials

Posted By: Jil Staszewski, Policy and Advocacy Manager

Starting this week, U.S. elected officials in Washington, DC will go into August recess. While Capitol Hill will grow quieter during the break, this doesn’t mean our advocacy activity should stop. In fact, this recess creates a unique opportunity for you as a constituent to help keep the momentum going right at home.

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ASHG members Lauren Tindale and Burcu Darst, and FASEB President Hannah Carey, met with Senator Tammy Baldwin in 2018.

As you may be aware, ASHG, along with FASEB, the Ad Hoc Group for Medical Research, and the rest of the biomedical research community has been busy advocating for a $41.6 billion budget for the NIH for Fiscal Year (FY) 2020 – a $2.5 billion increase from FY 2019. Last month, the House passed a $41.1 billion budget, and after the August recess, the Senate will begin developing its own legislation.

As your Members of Congress travel back to their home state or district offices for the remainder of the summer, scheduling a face-to-face meeting is a powerful way to establish a connection and advocate for your profession. Your personal story and achievements help your legislator understand the significance of your work in the state or district they represent, and why supporting NIH funding is crucial.

Not sure where to start? Here is a step-by-step guide (PDF version).

  1. Request the meeting.
    • Find your elected officials and their contact information using the House and Senate.
    • Email the legislator using the contact form or email address provided. In your email, be sure to confirm that you are a constituent, mention which institution you are from, and briefly describe the purpose of the meeting. Use the below template letter as a guide.
    • If you do not hear back within a week, you may follow up with the staff, as they receive many requests. Email again, and call the office and speak with the scheduler if necessary.

Dear Senator/Representative ______________:

My name is ____ and I am a geneticist and your constituent. I am writing to request a meeting with you and your staff in your district office to discuss the value of robust funding for the National Institutes of Health (NIH) and its significance for my work. I am available to meet on (date). Please let me know a time that would work best for you.

Thank you so much for your time, and I look forward to meeting with you to discuss this important issue. You may contact me at (email/phone #).        

Sincerely,

[Your name, institution, address, and contact information]

  1. Once confirmed, prepare for the meeting.
    • The purpose of the meeting is to educate your Member of Congress about the importance of the field, and the value of federal funding and its impact on your research. Bring a handout to leave with the legislator and read through the material beforehand.
    • Read up on the legislator you are meeting with. Having a shared personal connection can help develop a rapport and make a lasting impression.
    • Develop a list of questions the legislator might ask and how you can answer them.
    • Let ASHG know the date of your meeting and who you are meeting with.
  2. Attend the meeting.
    • Describe your job using layman’s terms, and connecting it to the legislator’s constituents.
    • Thank the legislator for their support on past relevant issues.
    • Explain why the legislator’s support of increased NIH funding would be valuable for your work, and that this year, the research community is asking for $41.6 billion.
    • Answer any questions the legislator may have and ask how else you can be of assistance.
    • Take pictures with the legislator and their staff!
    • Leave behind materials, including your business card, and ask for theirs and their staff’s.
    • Invite the Member to visit your lab.
  3. Follow up.
    • Send a follow-up email shortly after the visit, thanking the legislator and staffer for their time.
    • Let ASHG policy staff know how the meeting went! Send us an email at policy@ashg.org. We may ask you to share your experience to help other ASHG advocates.

We look forward to hearing your stories, and are happy to assist with any questions  – just email policy@ashg.org. Thank you for your continued advocacy.

Improving Access to Genetic Counselors under H.R. 3235, the “Access to Genetic Counselor Services Act” of 2019

Guest Post: Amy Sturm, MS, LGC, President, National Society of Genetic Counselors

Genetic and genomic innovation has made leaps and bounds to improve people’s health. As the technology has evolved, many delivery models have integrated genetic counselors into the healthcare team so that patients and their family members have access to them.

Indeed, the genetic counselor profession has grown rapidly and by year’s end, there will be well over 5,000 genetic counselors practicing across the country. This number should almost double in the next ten years to continue to meet the steady demand for our services. Most health plans reimburse genetic counselors and genetic counseling. In addition, delivery models are becoming even more diversified so that genetic counselors are available remotely to patients and other providers by phone and through telehealth.

Medicare Coverage and Reimbursement: A Challenge to Access

The one area that has held back access to genetic counselors is Medicare. Medicare currently covers and reimburses genetic counseling, as well as many genetic tests. However, Congress has not enacted legislation that would recognize genetic counselors as Medicare practitioners and because of this, Centers for Medicare and Medicaid Services (CMS) does not reimburse genetic counselors. CMS currently reimburses physicians and nurse practitioners for providing genetic counseling.

Lack of access has been shown to result in patient harm, such as incorrect interpretation of genetic test results, failure to identify individuals with genetic risk, and inaccurate risk assessments leading to inappropriate medical management. Another reason that CMS should recognize genetic counselors is because we are also a great resource in ensuring the correct tests are ordered, which may lower Medicare spending.

H.R.3235 Would Recognize Genetic Counselors as Practitioners

But there is good news! Representatives Loebsack (D-IA) and Kelly (R-PA) have introduced H.R. 3235, the “Access to Genetic Counselor Services Act,” which would have CMS recognize genetic counselors as practitioners. NSGC appreciates and thanks ASHG for supporting this important legislation.

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NSGC President Amy Sturm (right), with Congressman Brendan Boyle (D-PA). (courtesy NSGC)

The passage of H.R. 3235 would reverse current Medicare policies that limit physician referrals to genetic counselor services. Today unfortunately, because of arcane Medicare “incident to” rules, referrals to genetic counselors are limited under Medicare. Physicians and other providers who do not work alongside a genetic counselor, but who may want to refer to genetic counselors for the delivery of genetic services to their patients, would first need to refer their patient to a physician that actually works with a genetic counselor. This is extremely inefficient and is prohibitive. Medicare beneficiary access to genetic counselors is therefore very limited.

We are working hard with groups like ASHG to put pressure on Congress to enact this important legislation. Medicare needs to modernize in many ways, and this is a perfect example of how Congress can improve the delivery of genetic services. If you’d like to support this effort, please visit: https://www.nsgc.org/p/cm/ld/fid=612

ASHG, AMP, and Partner Groups Oppose New Bill Allowing Gene Patenting

Posted by: Jil Staszewski, ASHG Policy & Advocacy Manager

Recently, there has been a re-emergence of gene patenting, an old issue that could impact the future of genetic research and medicine. On Wednesday, May 22, Senators Thom Tillis (R-NC) and Chris Coons (D-DE), along with Representatives Doug Collins (R-GA-9), Hank Johnson (D-GA-4), and Steve Stivers (R-OH-5) released text for a draft bill that seeks to reform Section 101 of the Patent Act. If passed, this legislation would effectively overturn the 2013 Association for Molecular Pathology (AMP) vs. Myriad Supreme Court decision, which ruled that our genomes are not eligible to be patented, as they occur in nature. Essentially, the bill would allow for the patenting of genes.

Background

To provide a bit of history on the issue, back in 2009, AMP, along with the American Civil Liberties Union (ACLU), filed a lawsuit against Myriad Genetics, challenging the validity of Myriad’s patents on the isolated BRCA1 and BRCA2 genes. AMP argued that these patents created extraordinary burdens for researchers, as they skyrocketed the cost of related testing and prevented further innovation. ASHG and several other medical associations submitted an amicus brief in support of AMP’s claims. In March 2010, the case was heard before the United States District Court of New York, where the judge ruled that products of nature could not be patented.

Upon successful appeal by Myriad, the case was eventually heard by the Supreme Court. In 2013, the Supreme Court ruled that isolated genes were still considered products of nature, and were not eligible to be patented.

ASHG’s Position

This AMP vs. Myriad ruling has played a large part in fostering an environment where researchers and clinicians are unencumbered by patent barriers.

Reacting to the news of the pending legislation, ASHG President-Elect, Anthony Wynshaw-Boris, MD, PhD, stated, “ASHG remains firm with our support of the 2013 Supreme Court ruling of AMP vs. Myriad that established that naturally occurring DNA is not patentable because it is a product of nature. It allows researchers to investigate the entire genome without fear of legal barriers and repercussions, helping to advance genetic discoveries and the development of new diagnostics and treatments for patients.”

ASHG has signed onto a joint, multi-society letter to the proposed bill’s sponsors, in opposition to the bill.

Next Steps

This week, a two-part hearing titled “The State of Patent Eligibility in America” was held by the Senate Judiciary Committee’s Subcommittee on Intellectual Property, where Senators Tillis and Coons serve as Chairman and Ranking Member, respectively. In his opening remarks, Senator Coons stated that the bill does not intend to overrule the 2013 Supreme Court ruling, but instead hopes to draw the line for how much human intervention is needed to determine patent eligibility.

Senator Tillis, Chairman, and Senator Coons, Ranking Member, welcome the participants of the “State of Patent Eligibility in America” hearing.”
Senator Tillis, Chairman, and Senator Coons, Ranking Member, welcome the participants of the “State of Patent Eligibility in America” hearing.

In his testimony, Charles Duan, Director of Technology and Innovation Policy at the R Street Institute, disagreed with Senator Coons’ claims, citing that the draft bill “provides that patent eligibility inheres in any ‘invention or discovery’ that arises ‘through human intervention.'”

Also amongst the panelists was Kate Ruane, Senior Legislative Counsel at the ACLU, who stated that the draft bill’s proposed revival of patent claims on genes would essentially violate the First Amendment, as it would deny scientists the ability to freely study and research genes. A third group of panelists will testify for a final hearing early next week.

ASHG will be following this impending legislation closely in the next coming weeks, and will alert ASHG members on any significant updates or grassroots advocacy efforts that may require your action and support. To stay up-to-date on the issue, be sure to subscribe to our monthly policy and advocacy email updates.

Why is a 2011 Budget Relevant to Science Funding Today?

Guest Post By: Mary Woolley, President and CEO, Research!America

Each year, Congress develops a federal budget, which establishes funding for each federal department and agency for the following fiscal year. This determines how much funding agencies like the NIH have to support scientific research through grants, as well as in their own labs.

Budget Caps Threaten Research Funding

A federal law, the 2011 Budget Control Act (BCA), placed stifling caps on spending that have threatened funding for the NIH and other agencies. These caps are blunt tools that batter crucial national priorities, compromising security, prosperity, and progress.

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Research!America and partner organizations, including ASHG, are running ads urging Congress to #RaisetheCaps. (courtesy Research!America)

Why It’s Time to #RaisetheCaps

Because the caps established by the BCA are so low, Congress has raised them repeatedly to allow sufficient funding for federal agencies. Unfortunately, those “caps deals” were temporary. Unless Congress acts again, we’re looking at a cut of approximately $55 billion to non-defense discretionary spending in the next fiscal year, which guarantees trouble. If the cuts are distributed evenly or no budget deal is reached, then NIH and every other public health and science agency faces a cut of about 10%. In the case of NIH, that would mean a cut of as much as $4 billion.

Achieving another agreement to raise the budget caps is crucial, time-sensitive, and not by any means a sure thing.

You don’t need a laundry list of the negative consequences on science that these cuts would engender. Suffice it to say that promising research will be choked off, fewer new grants will be funded, and medical and other scientific progress will slow dramatically. All this during a time of unprecedented scientific opportunity, when other nations are already nipping at our heels and would surely attract more and more young scientists if the U.S. signaled lack of support. Starving research is not the solution to what ails us — literally or economically.

Your voices, your story, and your expertise are needed now. Tell your friends, colleagues, and Congressional representatives why medical progress, public health progress, and science itself are crucial, and why federal funding for these priorities is so important.

Research!America, supported by partner organizations including ASHG, has created resources for you to advocate for federal research funding. Additional resources and tools to urge your representatives to #RaisetheCaps are available on ASHG’s Advocacy Center.

 

Pivoting Your Career Toward Science Policy and Advocacy

By: Staff

ASHG and the National Human Genome Research Institute (NHGRI) co-sponsor the Genetics & Public Policy Fellowship to give genetics professionals an opportunity to contribute to the policymaking process. If you’re interested in the development and implementation of genetics-related health and research policies at a national level, then this Fellowship may be right for you. Applications are open now through April 19, 2019.

Questions about what the position is like? Read on for real-world details from past Fellows about their experiences.

How is the position structured?

The Fellowship lasts for 16 months, during which time the Fellow rotates through three positions within the Policy and Program Analysis Branch of NHGRI, a congressional office of a member of Congress or a committee, and the Policy & Advocacy Department at ASHG. This allows Fellows to gain experience in different roles of national policymaking and decide which aspects of policy and work settings they are interested in pursuing as a career.

2016-17 Fellow Christa Wagner said, “The ASHG/NHGRI Fellowship has provided me with a diverse array of experiences, both in terms of topics covered and settings in which I worked on policy. The Fellowship provides an exceptional experience for those with a background in genetics to play a role in effective policymaking.”

Cari Young, 2015-16 Genetics & Public Policy Fellow, walks us through her experiences.

What kind of work will I do? 

While it depends on the needs of each organization at the time of arrival, 2017-18 Fellow Nikki Meadows gave us a look into her work during two of her rotations through several blog posts.

Nikki Meadows 2017-18 Policy Fellow
2017-18 Fellow Nikki Meadows discusses advocacy with members.

During her rotation with the Senate HELP Committee, Nikki organized a panel of genetics experts to answer questions from congressional staff working on health issues. This allowed her the opportunity to network with seasoned geneticists and help enhance the scientific knowledge of congressional staff. At ASHG, Nikki also provided updates to members on important policy issues such as the federal biomedical research budget  and genetic privacy. She additionally promoted the ASHG Advocacy Center and encouraged scientists to make use of these vital tools, both at the 2018 Annual Meeting and through online forums.

While these certainly weren’t all of Nikki’s duties, she explored several areas of work with a variety of audiences. Nikki said, “I had some amazing opportunities during the course of this Fellowship. I’ve gained so much from this program, both personally and professionally, that I am forever changed by it.”

Will this position help further my career? 

The rotational aspect of the position is a huge bonus to many applicants. 2015-16 Fellow Cari Young said, “This Fellowship provided a unique opportunity to take on varied roles within the science and health policy landscape, allowing me to experience the pros and cons of working in each setting and helping me to crystallize my thinking on where I might want to go next. It also made me a more marketable applicant for policy positions beyond the Fellowship.” As Fellows gain experience in different areas of public policy in just 16 months, it is a vital starting point that lays a solid base.

Being a Fellow additionally opens a new professional network to benefit from. 2012-13 Fellow Laura Koontz said, “Not only has the experience been invaluable, the network of Fellows I’ve joined as an alumna are among the best policy professionals in D.C. The Fellowship has also allowed me to fully realize my commitment to bettering the lives and treatment of people with cancer – the reason I got into scientific research in the first place!”

What kind of jobs might I get afterwards?

Check out our policy fellowship page to see where all our past Fellows are working now! Our Fellows have gone on to positions at the National Institutes of Health, the U.S. Food and Drug Administration, the White House, and a number of other organizations focused on science and health.

Applications are open now through April 19, 2019. Apply today!

Voice Your Concerns about the U.S. Government Shutdown’s Impact on Science

Posted By: Staff

The American Society of Human Genetics (ASHG) deeply believes that ongoing federal government support is essential for the scientific enterprise in the United States. We affirm the important role of normal operations to keep scientific progress moving forward.

20190124_capitolAlthough – fortunately – the National Institutes of Health (NIH) is operational during the partial U.S. government shutdown, other science-based agencies that support and facilitate ASHG members’ work and that of their colleagues are not. Notably, the National Science Foundation (NSF) is affected.

ASHG is proud to stand with the Federation of American Societies for Experimental Biology (FASEB) in letting Congress know how the shutdown is affecting science. Please use FASEB’s Legislative Action Center to contact your members of Congress about how the shutdown is impeding progress and reaffirm the importance of science agencies in advancing research.