Is Oncotyping covered by MSP?

Options
CalamityJane
CalamityJane Member Posts: 26

Hi 

Just read an old thread from 2007 that said MSP in British Columbia did not pay for oncotyping and that it cost several thousand dollars...are there any updates on this? Reading the forum it sounds fairly standard in the US, and if you have the right numbers significant to your treatment.

thanks

CJ 

Comments

  • catbill
    catbill Member Posts: 326
    edited January 2011

    I think most MD's like the oncotype, and use it whenever possible.  It is very expensive, though.  I saw my bill  because my insurance has an electronic way for me to check and see when a claim gets paid.  It cost just under $4000.  Don't know about MSP, but worth checking out.  My oncotype of 8 (along with stage 1, grade 1) meant that chemo wasn't for me.  But no one said that until they saw my oncotype.  Best of luck.  Hoping for an oncotype for you.

  • hlya
    hlya Member Posts: 484
    edited January 2011

    No, it's not covered by MSP or extended health care in BC.

    But if you join the Tailox clinic trail you can get it done with no charge,  but you won't be able to choose the treatment, neither your doctor.  You will be randomly picked to take the treatment.

  • nikola
    nikola Member Posts: 466
    edited January 2011

    Hi,

    it is not covered in Manitoba. I tried to get into trial but got my results too late and was denied. I was waiting for Her2 results for 6 weeks (first inconclusive then sent for FISH). You have to be no more than 12 weeks from Your surgery to be accepted into the trial. I got my results in week 11 but they need at least 2-3 weeks for specimens to be prepared and sent to lab in US.

    Since I did not get the oncotype I opted to do chemo. I am 15 weeks from my last Tx.

    Good luck.

  • crazy4carrots
    crazy4carrots Member Posts: 5,324
    edited January 2011

    There's info on the test on this site -- go to Symptoms and Diagnosis at the top of the page, and then scroll down to Oncotype Dx.  The results of the Tailor-X Trial will determine the coverage in Canada but that probably won't be for a few years yet, unfortunately.  Since the company that developed the test owns the patent, it can charge whatever it likes for out-of-country patients!

    What I find so interesting about this test is that it appears to make little difference what one's stage or grade is.  Someone with a low grade and stage can turn out to have a high oncotype number, while someone at a higher stage and grade can quite possibly have a lower number.

    When I was deciding about chemo, I didn't know about the oncotype test.  I doubt that I would have paid out of hand for it, because I ultimately decided to do what felt "right" for me, and that was to do the chemo.    Sometimes you just have to go with your own instincts!

  • hlya
    hlya Member Posts: 484
    edited January 2011

    Hi, lindasa:

    Are you in Canada? it's not easy to meet an ILC friend here.....

    Also the Oncotype test use different methods to test the tumor cell's  characters, which means it's not associated with the grade/stage test, so it's independent.

    But I just saw a lady with low score 9 got reccurance in 4 years......hmmmmm

    As most of ILC are grade 2,  did the doctor ever tell you why yours is grade3? is it Pleomorphic type or traditional type? - there are very few studies about ILC and seems we have to figure out by ourselves sometime...

  • crazy4carrots
    crazy4carrots Member Posts: 5,324
    edited January 2011

    hlya:  Yes, I'm in Ontario.    I've read that sometimes there is discrepancy between Stage 2 and stage 3, depending on the subjective opinion of the pathologist.  Mine was traditional ILC, along with LCIS.

    Yes, I also have seen low oncotype scores and recurrence some years later so I wasn't too bothered when I found out about the test that I couldn't/didn't have.  I do wonder how much "faith" the majority of U.S. oncs actually put in it.  Then there's the added problem of getting a score which borders on the low/moderate risk.  I'd still go with my gut instincts!

  • Sharon789
    Sharon789 Member Posts: 56
    edited January 2011

    Hi folks,

    I'm in Ontario.  I had the Oncotype test in December 2010 and it was covered by OHIP.  I guess it didn't save the government any money because it turns out that I would benefit from chemo. I've just finished 2 of 4 rounds of chemo.

  • GG27
    GG27 Member Posts: 2,128
    edited January 2011
    Calamity Jane,  I just had a meeting with my onco & asked her about it, she said it's standard in the US because the insurance co's don't want to pay for treatment if they don't have to.    She said if I wanted to have it done it would be about $1,000. 
  • bellydancer
    bellydancer Member Posts: 59
    edited December 2011

    I am in MB . I wanted the Oncotype test so I spoke with my Med Oncologist. She had the information package and forms to facilitate it. I filled out the forms including the spot for my credit card number and her office made the arrangement for my tissue sample to be sent to Genomic Health in California. I was charged 4000 usd. It took the lab here 3 working days to process the request, then 6 days working days for Genomic Health to send the result to my Dr. They don't release the results directly to the patient.
    Note: Tailor X is not recruiting new patients.
    http://www.genomichealth.com/Publications/Publications.aspx?LinkId=9

  • crazy4carrots
    crazy4carrots Member Posts: 5,324
    edited January 2011

    Wow -- big discrepancy in costs between BC and Manitoba!  I wonder why?

  • nikola
    nikola Member Posts: 466
    edited January 2011

    bellydancer, like your screen name. Are you in Winnipeg? At the time I was applying for TailorX they were still looking for candidates (back in July). I am glad now I did chemo as it turned out I had three cancers in same breast.

  • bellydancer
    bellydancer Member Posts: 59
    edited December 2011

    Nikola, yes I am in Winnipeg : )...brrrrrrrrrr

    It was Nov 2010, when I was told Tailor X was closed, I think we both just missed it but for different reasons.



    Lindasa, Yes huge price different....hmmm... My Dr initially told me it was $3500. when I spoke with the genomic rep on the phone I received the 4k quote.

  • GG27
    GG27 Member Posts: 2,128
    edited January 2011

    Just to clear up any misunderstanding about the price.  My onco seemed to just throw out the price of $1,000, I don't know if this is how much it is, but this what she said to me.  I wouldn't have thought it would be that much difference.

  • hlya
    hlya Member Posts: 484
    edited January 2011

    mfrog: it should be around $3800 'cause they charge everybody the same from California no matter where you are.

    lindasa: May I know your score?

  • crazy4carrots
    crazy4carrots Member Posts: 5,324
    edited January 2011

    hlya -- I never had the oncotype dx done -- in fact, I didn't even know about it until I came here a month after finishing chemo.  In retrospect, I'm glad, because if the score had been high, I'd be feeling much more anxiety about a recurrence.  And if the score had been on the border between low and moderate, I'd still have to make the decision.  And if the score had been low, I'd probably always wonder if I should have done chemo.  I just read about someone with an oncotype score of 9 who five years later developed mets.  This test is not 100% infallible, I'm afraid.

    As I said, sometimes you just have to go with your gut instinct -- doesn't mean the results will be optimum, but it has to FEEL RIGHT TO YOU.

    Good wishes to you all!

    Linda

  • hlya
    hlya Member Posts: 484
    edited January 2011
    lindasa: yes, I saw that post too,  very scaring....Nothing can be sured when it comes with cancer: Chemo, Tamoxifen, Mastectomy, Oncotype test......I saw recurrence/mets from women who took all of these treatments and still can't prevent it from happening.....

Categories