Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.

Reuters NewMedia - August 08, 2002
Julie Steenhuysen

Now, for a handful of CVS drug store customers, the trip might also include a pre-paid card to receive hospital-quality lab tests for cholesterol, HIV, hepatitis C or even sexually transmitted diseases.

Tapping into consumers' increasing desire to take charge of their health care, Quest Diagnostics Inc.DGX.N , the nation's largest U.S. diagnostic testing firm, this week is making 12 of its laboratory tests available to consumers in 81 CVS/pharmacy stores.

The pilot program, being launched this week in Tampa and St. Petersburg, Florida, and Columbus, Ohio, takes aim at consumers who want basic health information without having to go through their personal physician, or health plan, to get it.

But some doctors and policymakers fear the tests will give consumers information they're ill-equipped to understand, and may produce a false sense of security for patients with risky personal health histories.

PEOPLE WANT CHOICE

Hughes Bakewell Jr., vice president of consumer health at Quest Diagnostics, said patients want to decide what tests they get--something they haven't been able to do in the past.

"People become very indignant when they find out they can't do this. They don't understand why," he said in an interview.

While pharmacies already sell a number of home test kits for pregnancy, glucose-level monitoring and even HIV, Bakewell said those kits require patients to draw their own blood, and still leave them wondering whether the results are reliable.

"We're offering people the same quality of laboratory testing that hundreds of thousands of physicians use every day," he said. Bakewell said Quest is the first major lab testing company to offer hospital-quality lab services in retail locations.

Consumers in Quest's test markets can buy specially encoded QuesTest cards, which work much like a prepaid phone card and range in price from $40 for a cholesterol test to $115 for a full health panel.

Consumers then take the cards to Quest's testing centers for the required blood or urine sample. Confidential results are posted on a secure portion of Quest's Web site (http://www.questest.com), or delivered in the mail.

Todd Andrews, a CVS Corp.CVS.N spokesman, said the retailer expects the partnership to help it position CVS as a "convenient way for customers who want to access these kinds of tests." He wouldn't say how much CVS would derive from the deal. CVS operates more than 4,000 drugstores in 32 states and the District of Columbia.

But Banc of America Securities analyst Todd Richter said he believes that, unless insurance companies reimburse the tests, the market potential is limited.

"Who is going to pay for this stuff? How big can the market be unless insurance at some point pays for it?" he said, noting that all 12 of the tests are covered by insurance companies when ordered by a doctor, but not when requested by a patient.

Still, he sees a clear increase in consumers' interest in calling the shots when it comes to their own health, noting the rise in holistic medicine, chiropractors and even a boost in vitamin use.

QUEST FOR YOUTH

Sociologist Lee Hargraves of the Center for Studying Health System Change in Washington says the Quest venture is another manifestation of Baby Boomers' desire to live longer, spawning a demand for total body scans throughout the country.

The much more costly tests -- ranging from $800 to $2,000 -- use large amounts of radiation to map out detailed images of a patient's internal organs.

Hargraves said the trend toward do-it-yourself health care also reflects a backlash against managed-care organizations that have restricted patients' access to health care.

"People are saying maybe they [doctors] are not doing everything they should. Now you can go out and do it for yourself," he said.

Doctors fear the proliferation of self-ordered tests might result in a flood of calls from patients seeking treatment that may or may not be necessary and eventually drive up health costs.

Family physician Robin Uchitelle, M.D., of River Forest, Illinois, believes the Quest scheme could result in some patients discovering conditions they hadn't known about. But she believes eliminating the doctor as gatekeeper can leave patients with too much information.

"What it gives you is more information than you know how to process without the construct and context you need to understand it," she said.

Moreover, she said, "People will self-select certain tests that they may not need done. If you've got lung cancer, who cares if your cholesterol is 161? It will distract people from seeking out appropriate medical care based on what they need."

In the end, such programs may just add more costs to the already burdened health-care system. "There's a saying in medicine," Uchitelle said. "Tests beget tests."

(Additional reporting by Ellis Mnyandu in New York)

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