Again, Dr. Holden, as with your comments in recent blog, "NCCN patient guide argues that the benefits of PCa screening now outweigh the harms," thank you! I would NOT otherwise known, use off-label to garner FDA approval, Medicare and commercial approval and ultimately M O N E Y.. As many who follow this blog are silent, your participation is appreciated if rarely expressed. Again reason to show financial support for this unique blog.
Thanks, Dr. Holden. If a doctor prescribes a test (or med) off-label, doctor's choice, will insurance cover it? AI says it might pay part; the rest would be out of pocket, U of Michigan says it charges $1200 or so for the test. Perplexity AI says:
Practical upshot for a patient on AS
A clinician could order standard MPS2 periodically in an active‑surveillance patient to look for signals of upgrading, drawing conceptually on the MPS2‑AS data, but that would be an off‑label application in terms of how the test is validated and billed. (FDA has not approved the new test, but has the original MPS2.
Whether insurance pays is uncertain; plans that cover MPS2 for biopsy decision‑making may push back if the chart clearly frames it as serial AS monitoring rather than pre‑biopsy risk stratification.
It depends on the insurance company and if the doctor is willing to write a Letter of Medical Necessity for say a man who wanted to avoid a repeat invasive biopsy. Sometimes they will base coverage on it if it's an NCCN recommended biomarker, which MPS2 is. Lots of variables. I found that Blue Cross Blue Shield Federal was more lenient for coverage than say Cigna or Aetna. Lots variables.
Thanks, Dr. Holden. Here's the company's response: “MPS2-AS is a new test specifically being developed and validated for use in the Active Surveillance setting. While it builds upon the scientific foundation of the original MPS2 assay platform, it is not simply ‘MPS2 with AS tacked onto the name,’ or a repurposing of an existing test.” I will have a follow-up story on MPS2-AS in the next few days.
Again, Dr. Holden, as with your comments in recent blog, "NCCN patient guide argues that the benefits of PCa screening now outweigh the harms," thank you! I would NOT otherwise known, use off-label to garner FDA approval, Medicare and commercial approval and ultimately M O N E Y.. As many who follow this blog are silent, your participation is appreciated if rarely expressed. Again reason to show financial support for this unique blog.
Thanks, Dr. Holden. If a doctor prescribes a test (or med) off-label, doctor's choice, will insurance cover it? AI says it might pay part; the rest would be out of pocket, U of Michigan says it charges $1200 or so for the test. Perplexity AI says:
Practical upshot for a patient on AS
A clinician could order standard MPS2 periodically in an active‑surveillance patient to look for signals of upgrading, drawing conceptually on the MPS2‑AS data, but that would be an off‑label application in terms of how the test is validated and billed. (FDA has not approved the new test, but has the original MPS2.
Whether insurance pays is uncertain; plans that cover MPS2 for biopsy decision‑making may push back if the chart clearly frames it as serial AS monitoring rather than pre‑biopsy risk stratification.
It depends on the insurance company and if the doctor is willing to write a Letter of Medical Necessity for say a man who wanted to avoid a repeat invasive biopsy. Sometimes they will base coverage on it if it's an NCCN recommended biomarker, which MPS2 is. Lots of variables. I found that Blue Cross Blue Shield Federal was more lenient for coverage than say Cigna or Aetna. Lots variables.
Thanks, Dr. Holden. Here's the company's response: “MPS2-AS is a new test specifically being developed and validated for use in the Active Surveillance setting. While it builds upon the scientific foundation of the original MPS2 assay platform, it is not simply ‘MPS2 with AS tacked onto the name,’ or a repurposing of an existing test.” I will have a follow-up story on MPS2-AS in the next few days.
Okay, it will be interesting to see what the MPS2-AS screens for other than the 18 genes in the MPS2.