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Barriers to obtaining gene expression profiling test heightened perceived value
Date:6/17/2014

ccurred in how oncologists discussed the test with their patients. Some oncologists offered the test to all their patients; others only to those who were eligible or where they felt there was uncertainty about the potential value of chemotherapy. Some raised it early in their consultations with patients, others late in the process, leading some patients to feel their doctors had already made the decision to recommend chemotherapy. Dr. Bombard said some patients felt information about the test was not offered to them because of its high cost, $4,000.

"Such delays or omissions in mentioning the test often left patients confused or feeling that something of great value was being withheld," she said.

Some patients said they learned about the tests from media reports describing a lack of funding in Canada that framed the issue as one of inequitable access to a highly effective, game-changing technology. Several of the oncologists said they felt pressured by the media coverage to offer the test to women for whom they knew it would not provide useful information for their decision-making about chemotherapy.

Another barrier was the extra paperwork around the test, which is not performed in Canada. Patients and oncologists must fill out forms to establish eligibility for OHIP reimbursement. Oncologists were then required to obtain government approval before sending tumour samples out of the country for testing. Results usually take about three weeks. This extra paperwork was cumbersome, increased anxieties about missing the window to start treatment and also reinforced the impression that the test was special, because it warranted special attention.


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Contact: Leslie Shepherd
shepherdl@smh.ca
416-864-6094
St. Michael's Hospital
Source:Eurekalert  

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