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Old 07-13-2007, 01:00 AM   #1
harrie
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Join Date: Mar 2007
Location: Hilo, Hawaii
Posts: 1,867
Oncotype: Ins denial

For those of you who had the Oncotype DX testing done, could you tell me if your insurance paid for the test?

My insurance denied payment based on the rationale that there is no scientific evidence that the Oncotype Dx test improves health outcomes nor is it the standard of care. They said while the National Comprehensive Cancer Network has extensively researched the tx of bc, including the role of Oncotype dx testing in risk stratification and tx decision making for early-stage invasive bc, a definitive recommendation has not been made for its use in this clinical setting. They noted that medical literature reflects that further studies are required to determine the role that prognostic marker studies such as the Onco dx have in guiding tx decisions for pts with early-stage invasive bc. Therefore the test is considered investigational and not a covered benefit.

Maryanne
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*** MARYANNE *** aka HARRIECANARIE

1993: right side DCIS, lumpectomy, rads
1999: left side DCIS, lumpectomy, rads, tamoxifen

2006:
BRCA 2 positive
Stage I, invasive DCIS (6mm x 5mm)
Grade: intermediate
sentinal node biopsy: neg
HER2/neu amplified 4.7
ER+/PR+
TOPO II neg
Oncotype dx 20
Bilat mastectomy with DIEP flap reconstruction
oophorectomy

2007:
6 cycles TCH (taxotere, carboplatin, herceptin)
finished 1 yr herceptin 05/07
Arimidex, stopped after almost 1 yr
Femara
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