Prometheus Test -- Scam? Legitimate? Necessary?

Prometheus is the name of a lab, and they do a number of different types of testing. The test I had was the Serology 7. I did the test in 2007, and they may have updated or changed it since then. They test different antibodies and can predict if you are more prone to UC vs. Crohn's and also can somewhat predict the severity of your disease course. If you have positive biopsies for Crohn's or UC, you don't need this test for a diagnosis. It is just one more piece of the puzzle. When I was being diagnosed, my colonoscopy was fine, but my disease was in my ileum, which the GI saw on the pill cam test. The Serology 7 test helped to confirm what he couldn't biopsy at the time. In a subsequent colonoscopy, he was able to get positive biopsies for Crohn's. The advantage of the Serology 7 test for me, was that I could start treatment in absence of positive biopsies.

There are also other tests through Prometheus labs that test you in advance of taking immunosuppressives or biologics. I'm not sure exactly what your doc is ordering and why, but your GI should be able to answer that question.
I don't believe that it is a scam, but I also think if cost is a challenge, then you might be able to skip at least the diagnostic test if your doc has good info from biopsies from the colonoscopy. I don't think the doc gets a financial benefit from ordering the test. IBD can be tricky to diagnose, so the docs like to gather as much info as they can. Prometheus, like many other drug companies and labs have patient assistance programs to help out patients, so they do charge insurance companies more that individual patients....that is not a scam. I hope this helps

I had what my GI called the "Prometheus test" as a blood test to see if I had any antibodies to Remicade or if I even had Remicade in my system still (it was at week 7). That knowledge helped my GI realize that Remicade wasn't working because I needed it more frequently and not because I had built up antibodies to it.

The tests that they use are experimental and unnecessary according to my insurance company, so they would not cover the tests. That cap of $250 was applied to me as well. I appreciated that they were willing to do a cap and not just be out to make money. They aren't a scam, and their test was vital to me because we probably would have just stopped doing Remicade and switched to Humira and assumed that I had antibodies to the Remicade. I am very grateful that I could stay on Remicade, just with more frequent infusions. I'd like to use it as long as it's effective and hold off on Humira for as long as possible.

So I would find out from your GI exactly what test he wants done and what information it will give him so that you can decide if it is worth the $250 or not.

scifigal2k said...
I had what my GI called the "Prometheus test" as a blood test to see if I had any antibodies to Remicade or if I even had Remicade in my system still (it was at week 7). That knowledge helped my GI realize that Remicade wasn't working because I needed it more frequently and not because I had built up antibodies to it.

The tests that they use are experimental and unnecessary according to my insurance company, so they would not cover the tests. That cap of $250 was applied to me as well. I appreciated that they were willing to do a cap and not just be out to make money. They aren't a scam, and their test was vital to me because we probably would have just stopped doing Remicade and switched to Humira and assumed that I had antibodies to the Remicade. I am very grateful that I could stay on Remicade, just with more frequent infusions. I'd like to use it as long as it's effective and hold off on Humira for as long as possible.

So I would find out from your GI exactly what test he wants done and what information it will give him so that you can decide if it is worth the $250 or not.

The Prometheus test for detecting antibodies to Remicade (ati's - antibodies to infliximab) is pretty new, so insurance companies are reluctant to cover it; but it's a critical test for some patients. As you stated, it helps determine why Remicade may not be working or is losing effectiveness. I expect that over time the insurance companies will start to realize the importance of this test and then they'll start approving it more often. After all, it could save them money by not having patients waste Remicade infusions that aren't helping them.

scifigal2k said...
I had what my GI called the "Prometheus test" as a blood test to see if I had any antibodies to Remicade or if I even had Remicade in my system still (it was at week 7). That knowledge helped my GI realize that Remicade wasn't working because I needed it more frequently and not because I had built up antibodies to it.

But you can up the dose without running a $5000 dollar test, which is exactly what my GI did with me. It didn't work.

Although I guess that meant the hospital had to pay for more Remicade infusions though :/ Never mind, it was a nice thought while it lasted.

Yes, Nestle Health bought Prometheus Labs in 2011.

Their insurance claim practices are indeed odd, but a lot of that is because the insurance companies have been resistant to covering any of their tests. Prometheus has for years tried to show the insurance companies that their tests can actually save money over the long term, but as you can imagine, insurance companies are only concerned with money here and now.

To the OP, this was discussed in the UC forum not long ago. I am thinking there is another company that does the testing & it is at a very much lower cost if I remember correctly. Or you can use the search feature here & type in UC forum & prometheus testing & can probably find the thread.