Avoid Prometheus Labs!

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Astromech
New Member


Date Joined Jun 2014
Total Posts : 16
   Posted 7/3/2014 12:03 PM (GMT -7)   
I have had two blood tests related to my Ulcerative Colitis that have been processed by Prometheus Labs. One was a genetic test to see if 6mp would cause me trouble and another to check the level of Humira in my blood, and now it looks like I will be on the hook for thousands of dollars.

To begin with, before the first test I was told before hand there would be a reduced rate if my insurance did not cover it. Now they are denying it. I call that bait and switch. And the second test is just for a flat out ludicrous amount of money.

So, if you suspect your health insurance is not all that great I recommend refusing all testing done by Prometheus! mad

ByeByeUC
Veteran Member


Date Joined Feb 2011
Total Posts : 4530
   Posted 7/3/2014 12:25 PM (GMT -7)   
Back some years ago my GI put thru some lab work to Prometheus. It was to determine if I had UC or CD. I had no idea my insurance wouldn't cover it. They claimed it was "experimental testing" and denied it. I was stuck with a huge bill. And that particular test isn't even all that reliable. Gigantic waste of time and money. Sorry you got stuck too. Try and fight it at least.
Marianne
DX Pancolitis in 2005. Family history of UC.
Tried every drug-even Remicade & Cyclosporine-Tried diets-nothing worked-wanted my life back!
Step 1: J-pouch surgery (Laparoscopic restorative proctocolectomy w/ temporary diverting loop ileostomy) 6-25-10
Step 2: Take down surgery (Ileostomy reversal) 10/8/10
No more UC and no more drugs!! Very happy j-poucher!! :)

ScienceGeek1234
Regular Member


Date Joined Jun 2014
Total Posts : 34
   Posted 7/3/2014 5:14 PM (GMT -7)   
BYEBYE,
I totally agree with you. Prometheus testing isn't definitive, and overall not very useful.

garylouisville
Veteran Member


Date Joined Aug 2012
Total Posts : 9088
   Posted 7/3/2014 5:44 PM (GMT -7)   
I don't know about it's usefullness or not. It gets a lot of bad hype but I'm not sure the bad hype is totally deserved. My GI believes in the tests as a tool to use. Most insurances will not cover it in network so it is a good idea to get a commitment in writing from these people ahead of time as to the cost if insurance does not pay.
Pentasa(500mg) 2 pillsX2; VSL 1 pillX2; Prescrip Assist Probiotic 1 pill X 2;Vitamin D3;Grape seed extract 400mg X 2; Canasa as needed; DAO as needed due to dietary histamine intolerance

Gave me trouble: Robinul; Zymactive, Renew Life Probiotic 80 billion, Florastor

Spartan4Life
Regular Member


Date Joined Jan 2014
Total Posts : 136
   Posted 7/3/2014 7:25 PM (GMT -7)   
If you don't use Prometheus, what tests do you have done to determine if you are reaching the concentrations of drugs like 6mp or azathioprine necessary for therapeutic benefit? My standard labs are fine, but my results from Prometheus show I'm not processing the drug well, am at an increased risk for liver toxicity and am not at the level of therapeutic benefit. We've based the decisions to move me off of 6mp to azathioprine off of the Prometheus results. Now we're making the decision to move from azathioprine to an infusion (hopefully vedo, but likely Remicade).

ScienceGeek1234
Regular Member


Date Joined Jun 2014
Total Posts : 34
   Posted 7/3/2014 7:31 PM (GMT -7)   
^^ I should mention that the Prometheus 7 test, which is used to diagnose Crohns vs. IBD is not of great value.

Thoreau
Veteran Member


Date Joined Jul 2009
Total Posts : 2127
   Posted 7/3/2014 8:39 PM (GMT -7)   
I had the "Answer IFX" test done by them last year to determine if I was gaining antibodies to Remicade. Before I did the test I got literature and phone confirmation that I would be held to no more than $250 of responsibility if my insurance did not cover it. Luckily my insurance (United Health Care at that time) did cover the test. But, it's always smart to check and see on those sorts of tests before you have them.

I feel it's shady though of any physician to prescribe the test if they have an idea that it might not be covered, and not forewarn you first.
"The price of anything is the amount of life you exchange for it."
29/Male
Dx 2003. Left sided UC that kept going futher, to halfway through colon.
Tried: 5-asa's, 6mp, Imuran (Plus all the other momentary treatments)
Remicade started 1/27/2012
In Remission **with severe body pains, likely from Remicade (started 7/2012)

Thoreau
Veteran Member


Date Joined Jul 2009
Total Posts : 2127
   Posted 7/3/2014 8:40 PM (GMT -7)   
Also, please argue with them and stand up for yourself if they did lie to you at Prometheus. That publicity could be very bad for them and they need to know that. Work your way through until you find someone that cares there.
"The price of anything is the amount of life you exchange for it."
29/Male
Dx 2003. Left sided UC that kept going futher, to halfway through colon.
Tried: 5-asa's, 6mp, Imuran (Plus all the other momentary treatments)
Remicade started 1/27/2012
In Remission **with severe body pains, likely from Remicade (started 7/2012)

garylouisville
Veteran Member


Date Joined Aug 2012
Total Posts : 9088
   Posted 7/4/2014 5:41 AM (GMT -7)   
My GI's office warned me that many insurances do not cover it and gave me an estimated cost if they didn't.
Pentasa(500mg) 2 pillsX2; VSL 1 pillX2; Prescrip Assist Probiotic 1 pill X 2;Vitamin D3;Grape seed extract 400mg X 2; Canasa as needed; DAO as needed due to dietary histamine intolerance

Gave me trouble: Robinul; Zymactive, Renew Life Probiotic 80 billion, Florastor

iPoop
Forum Moderator


Date Joined Aug 2012
Total Posts : 11047
   Posted 7/4/2014 6:16 AM (GMT -7)   
Most health insurance does not cover Prometheus labs tests. They can file up to 3 appeals to your insurance company. Prometheus should bill you only $250 if the test isn't covered. They also have a patient assistance program that drops the test down to $75 depending on proof of income.

http://www.prometheuslabs.com/Resources/Financial_Asssistance_Application_Form.pdf
Moderator ulcerative colitis
M, 35, proctosigmoiditis
Rx: Remicade 5mg per kg, every 8 weeks
Daily 75mg 6MP + 5g Lialda + Rowasa
Diet: Diet mods and supplements haven't done a thing for me

Post Edited (iPoop) : 7/4/2014 7:29:01 AM (GMT-6)


pink1
Veteran Member


Date Joined Jul 2010
Total Posts : 964
   Posted 7/4/2014 1:54 PM (GMT -7)   
My insurance refused to pay for Prometheus testing. My awesome GI sent them letters and journal articles on importance of testing (when I was messing w/ imuran dosage). And Aetna still refused. So I got stuck w/ the bills.
Tried: Entocort, Uceris, Mtx, Imuran, Humira, Remicade, Cortenema, Rowasa
Currently on: Apriso
As of last scope (6/14/14): Moderate to severe UC to 25cm

deltaforce
Veteran Member


Date Joined Jun 2010
Total Posts : 2242
   Posted 7/7/2014 4:41 PM (GMT -7)   
Spartan4Life said...
If you don't use Prometheus, what tests do you have done to determine if you are reaching the concentrations of drugs like 6mp or azathioprine necessary for therapeutic benefit? My standard labs are fine, but my results from Prometheus show I'm not processing the drug well, am at an increased risk for liver toxicity and am not at the level of therapeutic benefit. We've based the decisions to move me off of 6mp to azathioprine off of the Prometheus results. Now we're making the decision to move from azathioprine to an infusion (hopefully vedo, but likely Remicade).

From my knowledge, Prometheus is not *necessary*. You don't need to check therapeutic concentrations of these drugs. There is a fixed dose of these drugs and one should not go beyond that. Forgot the dose now, should be there in my older posts somewhere.
If you are not processing these drugs, you liver function will be markedly off and that is an indication to either lower the dose and stop cold turkey.

When I started Azathioprine, I wasn't even living in the US. All my Swedish GI did was to check my liver function every time before raising the dose, i.e. every 2 weeks. All well, go ahead, not well wait for 2 more weeks. Once I reached the dose necessary, 150mg, he checked function for 3 months, each months and then every 3 months. All went well, no worries at all.
Dx 03/2007, left sided UC.
Sulfasalazine 1.5gm, Vit. B12, 1mg, Multivitamin, 1 tablet, Fish oil 2400mg , Butyrate 2-3 caps, Vit D 10000 IU, Benebiotics 2caps, Folic acid 1mg. Canasa

Verapamil 320mg for migraine,
Nabumetone 750mg as an abortive, so far so good with GI side effects.
iHerb code BMV549
$5/$10 off on $20/$40 first purchase

I got uc
Regular Member


Date Joined Mar 2014
Total Posts : 79
   Posted 7/7/2014 6:16 PM (GMT -7)   
For a recent test the Prometheus lab rep. said if the insurance didn't cover it the cost would be $250, if I provided a copy of the EOB (explanation of benefits) as proof denial.
Severe left side UC 8-13/60/male/Kentucky
Humira 40mg, Prednisone 20 mg, Azathioprine X4, Apriso (Mesalamine) 0.375mg ER X4, Hyoscyamine 0.125mg, VSL#3, Senior multi vitamin, Calcium, Vitamin D & B12

Essential tremors and Chronic migraines for the trifecta. Meds, Amitriptyline, Treximet, Propranolol ER, Primidone, Hydrochlorothiazide, Gabapentin, Baclofen, Acetaminophen-COD #3

Cadillacwomen
Regular Member


Date Joined Jun 2015
Total Posts : 209
   Posted 11/18/2015 5:26 PM (GMT -7)   
I had the test to determine genetics, serology and inflammation. I am going to follow my doctors advice. I checked to see what was covered and what was not first. Some was and some was not. I'd suggest this for all medical tests. My GI told me it may or may not be. Sorry you had an issue but I'd also suggest contacting them again. Getting to irate can effect the results very negatively. Again sorry to hear
diagnosed April 2015 UC
MEDS for UC 2 Lialda and Endacort EC 9mg one Levbid er .375 MG. Ranitidine 150 MG as needed. Started on 6 mp 25mg Oct. 14 th 50 mg Oct 28th
Florastor, B complex, B12, vitamin D10,000 weekly and multi vitamin.

Other MEDs, levothyroxin, estrogen and allergy MEDS.flonase and citrizine.

Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 23549
   Posted 11/18/2015 8:16 PM (GMT -7)   
First of of all the original post was over a year ago. But 2 years ago I had a Prometheus test to determine the antibodies of Remicade in my system (which were fine btw) and even tho I consider myself lucky, I was responsible to pay $250. And before that, I also had the metabolite test to determine the 6mp in my system, I paid nothing. The prices that people have to pay for these tests tho are outrageous! How else are we to know how these meds are effecting us?? Seems it's a catch 22.
SHERRY
Moderator-Allergies/Asthma, Alzheimer's, IBS, Co-moderator-UC
Diagnosed Left sided UC '92 - meds: Apriso, Remicade (6mp discontinued due to neuropathy)*Unable to tolerate ALL mesalamines*, IBS, Diverticuliar Disease, Fibro, Sacroiilitis, Raynauds, OA, PA, Rosacea, Psoriasis, Dry eye syndrome and allergies controlled by Zyrtec.

Dikid
Veteran Member


Date Joined May 2015
Total Posts : 2235
   Posted 11/18/2015 8:43 PM (GMT -7)   
Mayoclinic does the exact same testing and my insurance covered it.
For the test to check for antibodies to remicade and the amount in serum the code was infxr and my insurance covered it
The hospital just sent my labs to mayoclinic and it took only 2-3 days to get results if I can remember correctly.
20 year old female
Diagnosed with severe uc on 4/27/15
Remicade 10 mg/kg
Imuran 50 mg
Multivitamin, biotin, calcium, and vitamin d

DRR
Regular Member


Date Joined Dec 2013
Total Posts : 65
   Posted 11/19/2015 4:59 AM (GMT -7)   
LabCorp offers some of the tests that used to be Prometheus only, such as the test for Remicade antibodies. My doctor did not know this - it's something I found out on my own - and I had to ask him to rewrite my lab orders so I could use LabCorp.
Male, 38, ulcerative colitis 11/2013. Prednisone dependent. Started Entyvio 10/15/15, also taking prednisone, methotrexate, amitriptylimne, Asacol HD. Tried budesonide, azathioprine, Remicade, Humira.

iPoop
Forum Moderator


Date Joined Aug 2012
Total Posts : 11047
   Posted 11/19/2015 5:14 AM (GMT -7)   
The thiopurine metabolites test is no longer exclusive to Prometheus, it's available by quest diagnostics and labcore to name a few. I've heard labcore has the infliximab(remicade) levels/antibody test. There are generic options available now that might be covered in-network for usa health insurances.
Moderator Ulcerative Colitis
John
, 37, UC in clinical remission
Rx: Remicade @5mgs/kg/8wks + 6MP @50mgs

You might have uc if ... you discover a floater carelessly left behind and experience poop envy, not disgust.
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