[ElaineM]

You might want to re connect with Genetech and see what they would suggest about your circumstances.
You might also want to contact the drug company that makes Halaven and see if they have some kind of financial assistance program.
I also agree about making an appeal. Go the normal route, but also try to find a higher level person at the insurance company to contact about this problem.
Your insurance company has no business dictating the treatment your wife must or must not receive. The insurance company does not know your wife's completel medical history and current situation.
Whether or not somethings gets approved may depend on how a doctor writes up an authorization form for the insurance company. Perhaps your wife's doctor would be willing to make a stronger case by wording the request differently. Maybe how your doctor plans the treatment might make a difference too. Maybe doing the Halaven weekly and doing the Herceptin every 21 or or every 28 days when your wife can take a Halaven break might help get the insurance to pay for it.
Maybe Sheila has some suggestions about getting insurance to pay for it. I think she took Herceptin and Halaven successfully for skin mets.
Good luck. Take care.