[CabinGirl]

Cost of minimal residual disease (MRD) testing?

by CabinGirl on Wed May 17, 2017 10:23 pm

I'm wondering if anyone knows what the cost of minimal residual disease (MRD) testing is? My myeloma specialist at Mayo in Rochester, Minnesota would like me to have a bone marrow biopsy and MRD testing. I had an auto stem cell transplant at Mayo in February 2014 and have been on Velcade maintenance every other week since my Day +100 checkup. I reached stringent complete response (sCR) and continue to have no detectable M-spike.

My reason for asking about cost is that Mayo is considered "out of network" for my insurance and I would have to incur the entire expense for the bone marrow biopsy and the MRD testing, lab fees, etc. I've spoken to Mayo and they've given me the cost of a bone marrow biopsy, but the rep­resentative in their estimating department did not have any information regarding MRD testing. She said she would look into it and get back to me, but I was wondering if anyone on The Beacon has seen a recent charge from a cancer center or hospital that would indicate what MRD testing would cost?

I am considering asking my local Minneapolis oncologist to perform the bone marrow biopsy in his office and get the marrow sample to Mayo. At least that way the expense of the bone marrow biopsy would be covered as "in-network". Then that creates another question I have which is: once a marrow sample is extracted, how quickly does it need to be processed in the lab performing the minimal residual disease testing?

[blueblood]

Re: Cost of minimal residual disease (MRD) testing?

by blueblood on Thu May 18, 2017 10:49 am

Cabingirl,

I usually have my minimal residual disease tested via multiparameter flow cytometry (MFC), and my insurance took care of things.

Last week, however, my bone marrow biopsy was "sent off" to be tested via next generation sequencing (NGS) for minimal residual disease.

Unfortunately I don't know the cost of either test.

Hope this helps,

Craig.

[rick]

Re: Cost of minimal residual disease (MRD) testing?

by rick on Thu May 18, 2017 3:40 pm

Hi Cabingirl,

We were quoted a charge of ~$7000 (in 12/2015) when we asked about the cost here in northern California. We had Kaiser insurance at the time (since changed) and this quote had a few caveats. That was the charge, not the actual payment. That was if it wasn't covered by insurance, and as almost all MRD testing is done at specialty labs as "send out testing," it is out of network almost by definition. We were later told it was closer to $2500 by the team we are with now, so I think it's great that you are asking Mayo to get you better information.

That said, we have an annual "out of network" and maximum co-pay on our plan, which we burn through each year by March. So any cost after March is really moot for us.

You might ask your specialist to seek prior authorization for coverage, and I think you'd both have a compelling case and interest by your insurance provider. If you are both in sCR and MRD negative after 3 years, it might change your decision on maintenance treatment.

My husband had MRD testing pre- and post-transplant and was negative each time. We will have it annually (next in July-August) through year 3. Our provider feels if he is negative at year 3, there is much less likelihood of a myeloma recurrence. He hasn't yet said what the plan would be then, but this is an evolving topic.

Good luck.