Without competition, Myriad can effectively charge whatever it wants. Later this year, the company said it would begin incorporating the BRCA test into a 25-gene cancer-risk evaluation and phase out the à la carte BRCA test by 2015. For that broader test, it projects a gross profit margin of 87 percent.

Myriad says that the lack of competition in the United States has little to do with the price of its BRCA evaluations — and points to Europe, where health-system reimbursement rates are higher even though dozens of providers offer the test. But if this is the model for the future — when testing for genetic markers is certain to become a far greater part of health care than it is now — we’re all in trouble.

I’m all for innovation and the right to protect intellectual property, but when there is a clear monopoly and human lives are at stake, we need legislative action for rational and appropriate pricing. We don’t make vaccines prohibitively expensive so only the rich can protect themselves. Nor should we let other preventive measures that can save thousands of lives be priced at levels far above what normal “market conditions” would suggest.

Dana Goldman, a health economist at the University of Southern California, says one solution is a licensing model that would reward innovators for developing a test, but let it be widely distributed, at low cost. In the case of a diagnostic test like that for the BRCA genes, for example, insurance companies could pay for the intellectual property, buy a license on behalf of their insured customers (you and me), and then make sure as many at-risk individuals as possible were tested.

This is essentially the same strategy the French government used in 1839 when it purchased the patent on photography from Louis-Jacques-Mandé Daguerre and then put the rights out to the public domain (except in England), so that the whole world could benefit.

Not every woman, even those who have a strong familial history of breast cancer, wants to know if she carries a BRCA mutation. But all women with some risk factors for this genetic variant should be able to decide whether to be tested, without regard to cost.