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I think some ins companies will cover tykerb. I was given herceptin off-label and my ins paid. I have Healthpartners and when I spoke with them about it they consider a drug experimental if the fda has not approved it for that use. So, Herceptin was approved for breast cancer, so they covered it. It did not matter that it was only approved for stage 4, as long as it was approved for breast cancer it was covered. They would also cover tykerb for me, even though I am only stage 2, under the same reasoning.
I am an attorney and my opinion is the fight is going to have to be an individual one against her insurance company. I would find out now how your ins co defines experimental, and see if there are any arguments to be made that tykerb does not fall into that category for you.
Laurie
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