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Crohn's Disease Forum » Treatment » Remicade/Infliximab » Prometheus Anser IFX Antibody test


03-27-2014, 04:49 PM   #1
owr
 
Join Date: Jan 2012
Prometheus Anser IFX Antibody test

Hi folks,

I'm hoping some of you have experience with this lab, because Im unable to get any definitive answers otherwise.

It's 4 weeks after my 5th dose of Remicade. Ive had Crohns for ~20 years, been through pretty much all the meds and a couple surgeries and am also taking Azathioprine.

At this point in the cycle my Dr. likes her patients to get the Prometheus Anser IFX lab done exactly 4 weeks after their 5th infusion. As I understand it, it measure antibodies your body has built up to combat the medication and gives us an indication of whether or not Remicade will be a long term solution. It has definitely helped, but I did have a flare a few weeks back that put me in the hospital with a partial small bowel obstruction (lots of scar tissue and stricturing)

The problem with this lab is that it is not FDA approved (as I understand it) so most insurance companies reject it. The cost is $2500. After talking to Prometheus labs, they explained that they will bill my insurance and then go into negotiations once it is rejected. This can last up to 9 months. Once a final decision is made, if the insurance company flat out rejects it, the lab bills me $250 and eats the rest. I would do that, Ive spent a lot more than that in this journey. The worse outcome is if the insurance company accepts some part of that, say $1000 or $1500, since its out of network, I have a separate out of network deductible of $3000 so will end up paying the full residual amount out of pocket.

Has anyone been through this process? Any experience, especially with Blue Shield of California or similar is appreciated.

Thanks!
06-12-2014, 08:01 PM   #2
Camus
 
Join Date: Jun 2014
Late response, sorry but i just came upon this forum. Not sure why your doc wants this test at this phase of you illness. No lit supports use to predict effectiveness. Some nice evidence that it might help predict if a chnge in drug is better than increasing the dose or shortening the duration.
Way to expensive to order without good science behind the benefit.

Miss the old days when science was for the common good not profit. Imagine if Fleming patented penicillin, or leuenhauk using the microscope to look at red cells.
06-12-2014, 09:33 PM   #3
owr
 
Join Date: Jan 2012
Thanks for the reply, I appreciate it.

Ironically I put off having this test for the last few months up until about 2 weeks ago. Already had the test, haven't seen the results yet (will soon) and tentatively waiting for the bill. My doctor was actually not pushing it hard either way, especially after she heard about the potential cost. The good news is that none of her patients who have had it done have had to pay the full amount out of pocket, so I'm hoping it works out. End of day this disease is expensive...

I decided to go for it after experiencing some recurrent chest pain (right side) for the first 4 weeks or so after infusion, then it gradually fades. A CT scan after a recent hospitalization also revealed some fluid build up around my heart. So the test may cost a lot, but I want to know as soon as possible if my body is building up antibodies that would render Remicade ineffective and increase the chance for severe reactions.

On the positive side, 9 months or so into this drug and I just had my best colonoscopy in 15 years. So its (presumably) doing something good.
06-13-2014, 08:51 PM   #4
Camus
 
Join Date: Jun 2014
Good Luck. Thoughts and prayers for your continued good health.
09-16-2014, 11:32 AM   #5
nogutsnoglory
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Is one able to get this test at any time? Can I get it before my next infusion or should I wait till after infused?
09-22-2014, 08:32 PM   #6
araceli
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nogutsnoglory. I guess it depends on your Dr. My daughter's GI does not order the test unless He thinks something is going on like having flare-up symptoms before next infusion or having reaction to infusion. She was tested due to having vasculitis signs right after remicade infusion, remicade drug level was also tested. He choosed to test for levels about 4 weeks after infusion. For antibodies I don't think it matters when is done. Her levels were good and no antibodies detected.
owr. I hope your results are good. So glad remicade is making you feel good.
__________________
Mom/ Girl 19
dx 2011 crohn's in terminal ileum, peri-anal
Prior Meds Asacol, Prednisone, nexium
Current meds.
Remicade since Nov. 2012
Supplements
5000 Vit. D, Multi-Vitamins with Iron
Currently in REMISSION :dance

Mom/ 16 boy
Amplified musculoskeletal pain
Prior. Prednisone, sulfasadine,
Currently. Celebrex, gabapentin, amitriptyline.
09-22-2014, 09:49 PM   #7
Tesscorm
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My son had this test done twice and both times was either the day before or the morning of his infusion. The purpose was to determine the amount of medication just before the infusion. The first one was done the day before his first 8 week infusion (ie after 3 loading doses), as this showed no remicade in his system, he was moved to a six week cycle. Tested again and this time showed adequate levels lasting from one infusion to the next.
__________________
Tess, mom to S, 22
Diagnosed May 2011

Treatment:
May-July 2011 - 6 wks Exclusive EN via NG tube - 2000 ml/night, 1 wk IV Flagyl
July 2011-July 2013 - Supplemental EN via NG, 1000 ml/night, 5 nites/wk, Nexium, 40 mg
Feb. 2013-present - Remicade, 5 mg/kg every 6 wks
Supplements: 1-2 Boost shakes, D3 - 2000 IUs, Krill Oil
12-22-2014, 06:05 PM   #8
Bphoto
 
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My son is supposed to have this done tomorrow and we were told the same thing about the insurance. We were told that if the insurance rejects, the company will only charge a maximum of $250.00….I really hope that is true!
I was trying to get some info about this test…is it just a blood test? I'm not sure how much time to allot for it…
Thanks!
12-22-2014, 08:14 PM   #9
Clash
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Yes, it's just a blood test. It can take a couple weeks for the results to come back.
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Clash
Mom to
C age 19
dx March 2012 CD

CURRENT MEDS: MTX injections, Stelara


Dx May 2014: JSpA
8/2014 ileocecectomy
9/2017 G tube

PAST MEDS: remicade, oral mtx, humira
12-22-2014, 08:23 PM   #10
Bphoto
 
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Thank you!
12-22-2014, 08:59 PM   #11
Polaris
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I had this test done when I was about 4-5 infusions in and it came back positive for antibodies (I asked my GI to do it because although at first Remicade worked great, its effects started diminishing). Luckily my insurance (Kaiser Permanente) covered the cost no questions asked. I'm now having the same test done, with the same company, for Humira since it's not seeming to work anymore either.. I've been in a bad flare for the past 3 months.
02-24-2015, 02:39 PM   #12
Punkins/mom
 
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I am new to this site.. My 14 year old daughter PUNKIN (just her nickname) was diagnosed with Crohn's in August 2013. Durning that time I was a single mom and with this Prometheus Labs, I as able to send in my current pay stubs and W-2's. Since it was myself and my 3 children they got my payments down to $75.00 for each test because my insurance didn't want to cover due to out of net-work. I am remarried now and my payment out of pocket is only $250.00, insurance still out of net-work.. I have never had any issues with this lab and we are currently on our 6th test with them. The doctor that she see's is AMAZING by the way and they only request that it be done when she is having a lot of issues.. She is doing much better at this point with the Remicade every 6 weeks currently talking about moving her back to every 4 weeks, she is on the 6-MP, Iron and a few other vitamins everyday as well. I am ok with the 4 week Remicade treatments only because it will help her and I see how bad the last 2 weeks are on her before the next treatment. We are getting there with great doctors and lots of great support.
She is one of the strongest young ladies, that I know and she tells me that she will not let this get her down..

I wish you all the best and that you get the best results with prometheus labs. I just picked up the phone and called them truly friendly people there and very understanding.
1-888-892-8391 in Los Angeles, CA

Punkins, MOM
03-20-2015, 05:09 PM   #13
jonique
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I am new to this site.. My 14 year old daughter PUNKIN (just her nickname) was diagnosed with Crohn's in August 2013. Durning that time I was a single mom and with this Prometheus Labs, I as able to send in my current pay stubs and W-2's. Since it was myself and my 3 children they got my payments down to $75.00 for each test because my insurance didn't want to cover due to out of net-work. I am remarried now and my payment out of pocket is only $250.00, insurance still out of net-work.. I have never had any issues with this lab and we are currently on our 6th test with them. The doctor that she see's is AMAZING by the way and they only request that it be done when she is having a lot of issues.. She is doing much better at this point with the Remicade every 6 weeks currently talking about moving her back to every 4 weeks, she is on the 6-MP, Iron and a few other vitamins everyday as well. I am ok with the 4 week Remicade treatments only because it will help her and I see how bad the last 2 weeks are on her before the next treatment. We are getting there with great doctors and lots of great support.
She is one of the strongest young ladies, that I know and she tells me that she will not let this get her down..

I wish you all the best and that you get the best results with prometheus labs. I just picked up the phone and called them truly friendly people there and very understanding.
1-888-892-8391 in Los Angeles, CA

Punkins, MOM
Hi Punkins Mom, when your daughter starts to flare before the next infusion, how long does it take for her to recover once she has the next infusion? I just had my 4th infusion this week but started to flare up at about 6.5 weeks. I had the infusion two days ago but am still having symptoms of both crohn's and the spondyoarthropathy. hoping it will go go away soon!

I had the drug level test done on Monday but don't have the results yet. It was covered by my provincial health insurance.
__________________
Dx:
Crohn's Disease
IBD associated Spondyloarthropathy
Migraines
Moderate Fatty Liver

Meds:
5-ASA (Salofalk)
Celebrex
Omeprazole


Previous meds:
Stellara, Cimzia, Simoni, Remade, Humira, Methotrexate, Entocort, Sulfasalazine

Surgery:
1. laparotomy 1986 - Dx Crohn's Disease
2. small bowel resection 1995
3. small bowel resection 2016
03-20-2015, 06:48 PM   #14
lookame
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I had the test. I showed I needed to be on a double dose of Remicade. It helped bUT 2 yrs later I became allergic to it...it was kind of a sudden thing and I was recently pregnant so that may have had something to do with it.
__________________
Diagnosis: Confused officially diagnosed in 2010

Bloodwork is indeterminate IBD, biopsies are crohns positive, symptoms and visually it's UC

Current meds-
Prednisone, humira, 6mp, and lialda
awaiting surgical consult

Mom of Little Z
eosinophilic esophagitis 5/2015
02-27-2016, 04:50 PM   #15
W Pounds
 
Join Date: Feb 2016
We had a terrible experience with Prometheus and the Anser IFX Test.

Our physician at Mass General Hospital ordered this test for our son to see if he had developed the antibody to Remicade. William had used Remicade to control a flare about 5 years earlier, and then had stopped.

The Anser test showed that he had not developed the antibody, and that it would be appropriate to administer Remicade. This finding turned out to be WRONG. About halfway through his infusion, he had a severe and scary allergic reaction that was fortunately addressed with a strong dose of steroids and antihistamines.

We expressed our dissatisfied to Prometheus on three counts:
1. The test proved wrong, and yet we and our insurance was billed for both the Anser test and the expensive infusion of Remicade that the test should have told us to avoid had it provided accurate results. We would have been better off to skip the Anser IFX test altogether.
2. At $2500 retail, the Anser test is inappropriately expensive, for the apparently uncertain results it provides.
3. The Anser test/lab is not in the Blue Cross formulary, and they rejected the claim. Prometheus tried for a while to see if they could extract $2,500 out of us - for this failed test - before reducing their charge to $250.

I requested that Prometheus withdraw its bill for this failed test. They did not respond, and threatened to send the bill to a collection agency.

Caveat emptor. If your physician proposes to use the Anser IFX Test, know what you're getting into and be careful!
02-28-2016, 03:02 AM   #16
tots
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I was also told by my drs office if its a negative test my ins can the refuse any bills related to my CD. For that reason I declined to do it. Its also not really accurate for a lot of people.


Good luck


Lauren
__________________


Diagnosed= 1992 and again Feb 2012 Confirmed with
CT enterography May 2015 !!


Waiting for the ok from my Ins company to restart Remicade. Will also start Imuron to get into remission!
I know it's out there somewhere and I WILL find it!


:


Ok, my family Dr told me to cut down on the stress- a husband, 3 kids, and 3 dogs!
03-05-2016, 03:06 PM   #17
W Pounds
 
Join Date: Feb 2016
One more thing to add to the post above. I spoke with a representative at Prometheus, who stood by their test despite its failure in our case.

In addition to this unsatisfying outcome, I need to report that the company represents itself inaccurately. I was told by their representative that they're a "small company" to explain why they're not able to engage with all insurers to get their drugs covered, among other hardships. (Our insurer is Blue Cross, which you might think would be at the top of their list.)

Prometheus has revenues of over $250M per year - and this does not put it in the ranks of big pharma companies. However, Prometheus is wholly owned by Nestle, one of the largest 100 companies in the world, with revenues of $100Bn - hardly a small struggling enterprise.

Given their mission to help people with Crohn's I wish I could like and admire this company more. But their business practices and conduct make it really hard.
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