More Insurance Now Paying for Fibromyalgia Test

More Insurance Companies Now Paying for Fibromyalgia Blood Test – National Pain Report

Do you have a family member, friend or physician who doubts you have fibromyalgia? Well, there’s a little-known test you may not have heard of that could finally prove you’re really sick.

In 2013, Los Angeles-based biomedical company EpicGenetics made international headlines when it introduced FM/a, the first ever fibromyalgia blood test.

FM/a is covered by most Medicare plans. Private insurers, such as Blue Cross Blue Shield, UnitedHealthcare and Aetna, also are starting to pay for the test on a case-by-case basis.  

The test’s steep price tag – $794 – has been a deterrent for patients, many of whom are already living on fixed incomes because they’re unable to work due to poor health.

EpicGenetics is trying to make it easier for patients to afford the test by providing free assistance with insurance processing. The company’s insurance processing department contacts insurance companies on the patients’ behalf to find out if the test is covered and what the cost would be to the patient.

“The majority of physicians do not believe that fibromyalgia is real, so they haven’t kept up with the advances that have occurred, including reading something as simple as WebMD, which tells everyone the test exists,” he says. “In under 10 seconds, a Google search reveals the test.”

The legitimacy of fibromyalgia has been complicated for decades because of the lack of a diagnostic test to prove its existence. It’s typically a diagnosis of exclusion – meaning illnesses with similar symptoms have been ruled out through extensive (i.e. often expensive) medical testing.

A licensed healthcare professional must order the test for the patient. The test requires a simple blood draw, and results are available within five to seven days. It has a sensitivity of 93 percent – equivalent to the blood test for HIV. (No test has a sensitivity of 100 percent.)

The test focuses on four chemokines and cytokines, which are found at reduced levels in fibromyalgia patients, according to Gillis.

“These people [with fibromyalgia] have immune system dysfunction,” he says. “These people are really sick. It’s not in their head. … Why aren’t the drug companies knocking down our door to develop a treatment?”

EpicGenetics’ research and the FM/a test aren’t without critics. Fibromyalgia expert Dr. Daniel Clauw has said EpicGenetics’ studies contradict other research, which has shown normal or elevated cytokine levels in fibromyalgia sufferers.

The above is what I’ve been led to believe: that an excess, not a shortage, of cytokines is problematic.

Here’s some basic information about cytokines from Wikipedia:

Cytokines are a broad and loose category of small proteins (~5–20 kDa) that are important in cell signaling. They are released by cells and affect the behavior of other cells.

Cytokines include chemokines, interferons, interleukins, lymphokines, tumour necrosis factor but generally not hormones or growth factors (despite some overlap in the terminology).

They act through receptors, and are especially important in the immune system; cytokines modulate the balance between humoral and cell-based immune responses, and they regulate the maturation, growth, and responsiveness of particular cell populations. Some cytokines enhance or inhibit the action of other cytokines in complex ways.[3]

Normal tissue integrity is preserved by feedback interactions between diverse cell types mediated by adhesion molecules and secreted cytokines; disruption of normal feedback mechanisms in cancer, threatens tissue integrity.[21].

Over-secretion of cytokines can trigger a dangerous syndrome known as a cytokine storm.

But in 2012, the American Association for Clinical Chemistry gave EpicGenetics an award for outstanding research in clinical and diagnostic immunology for its fibromyalgia research, says Gillis.

He believes there’s a darker reason why Wolfe has been outspoken about the FM/a test:

Wolfe has previously received research funding from Pfizer, which makes Lyrica, one of three drugs approved in the U.S. to treat fibromyalgia and one of the most profitable pharmaceuticals in the world.

If it was proven that fibromyalgia patients actually have a malfunctioning immune system, then what sense would it make to treat that with an anti-seizure medication?

Pfizer and other pharmaceutical companies that make fibromyalgia drugs would lose billions.  

I find it demoralising that everything published about our health has to be evaluated through a “follow the money” filter.

 

Other thoughts?

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.