New Prometheus test

So the GI office called total and asked for me to get the Prometheus anser Ada test which is the newest one they offer. They suggested to check insurance first and then Prometheus has a plan to cap the cost. So I check my insurance, blue cross, and the don't cover it as they STILL consider this investigational. So then I look into what Prometheus offers to help with cost. I don't qualify, I did not hunk that I would. But get this....how much do you think the cost of these test which includes a nurse coming to your house?????......$2,500!!!!!! That is outrageous. So I called the GI back and said I want to wait as I don't have that money to cover it as I have 2 in college this fall. I also reminded them that I had the older version for remicade and my cost was $250 I which I would have paid if it was still that cost. In that test, I was fully loaded with the drug and showed no antibodies, so I am not sure hip this would show anything different.

Anyway, has anyone else had the newest version and seen this high of cost for it?

Ncot. I agree thus I said I wanted to wait. But geezzz look at the total costs to manage this deseases.

Hi I also would wait on that test. I had the old Prometheus test
done a long time ago. I think its wrong that our insurance co.
won't even pay for any part of this test.

The Serology 7 prometheus test I had back in 2007 was to help diagnose the Crohn's. Is this new test for antibodies to see about the Remicade, or is it still just to get a diagnosis? If you have already been diagnosed it doesn't make sense.
I tested positive and my numbers indicated very aggressive disease, and up until now, my crohn's is still considered mild. It was a very depressing result to get. At the time, my Crohn's diagnosis was questionable, so it did help along with my biopsies to confirm my diagnosis. My insurance covered it though, and it was the $250.00 test, not the one you are describing.

I just had the test that looked for antibodies to Remicade. My GI's office said they checked insurance first, but I just got a check in the mail from my insurance paying for $1900 of the test and we are responsible for the rest (~$500). This has never happened before, usually my insurance just covers it and we never handle the money. What a waste! I say hold off as well. These Prometheus tests are expensive and not traditionally covered through insurance (and I have really good insurance), which is infuriating.

Here is the info from the Prometheus website: http://www.anserifx.com/about.aspx

My impression after reading it is that the test will help you find out if you are developing antibodies to the humira, so it can answer the question of whether to increase the dosage or switch to another medication.
I think your doc already knows that you still have active disease, so the current dose of Humira is not adequately getting you in remission. So if you have antibodies, then you are not responding to the medication and continuing it is useless. At least that's how I interpreted the information. So maybe the test is worth it as otherwise it is all trial and error. I suggest that you contact Prometheus labs directly and see if they are willing to give you a stipend or discount since your insurance doesn't cover it. It is ridiculously expensive!!!!

So...if you still want to get the test to confirm if you need a stronger dose or to eliminate the med, I have another idea.

Have your GI write a letter to your carrier explaining the purpose of the test is to modify the Humira dosage for approriate care.  if thye note that it could prevent you from needing a larger dose or could remove you from the drug, it may make the carrier reconsider the value of the test.  If your doc can prove medical necessity while pointing out potential cost savings, it may change the opinion of the carrier.  I am not promising anything here, but it does happen. (Heck I did this for a simple 3.58 bill on a vitamin that was not OTC so ti was easy, but I have seen other tx arguments carry)