Fibromyalgia Blood Test Gets Insurance Coverage
/By Pat Anson, Editor
The founder of a bioresearch company that offers a controversial blood test for fibromyalgia says the test is now covered by Medicare and some private insurers. But questions remain about the viability of the test.
“Insurance has really been the big issue for us. That was the hump we really needed to get over,” said Bruce Gillis, MD, the founder and CEO of EpicGenetics in Santa Monica, CA.
“We are a Medicare approved laboratory. It covers 100% of the test. We are getting private insurance companies that are reimbursing for the test. And we have gotten most Blue Cross Blue Shield agencies to pay for the test.”
“We are a Medicare approved laboratory. It covers 100% of the test. We are getting private insurance companies that are reimbursing for the test. And we have gotten most Blue Cross Blue Shield agencies to pay for the test.”
EpicGenetics introduced the FM/a test in 2013, calling it the first definitive blood test for fibromyalgia, a poorly understood disorder that is characterized by deep tissue pain, fatigue, depression and insomnia. The test costs $775 and results are usually available in about a week.
Gillis told Pain News Network that with insurance coverage now available he expects more people to take the test. He projects his lab to analyze its 5,000th FM/a test by the end of the year.
IMAGE COURTESY OF EPICGENETICS
The test looks for protein molecules in the blood called chemokines and cytokines, which are produced by white blood cells. Fibromyalgia patients have fewer chemokines and cytokines in their blood than healthy people, according to Gillis, and have weaker immune systems as a result.
But critics have contended that the same immune system biomarkers can be found in people with other illnesses, such as rheumatoid arthritis, making the FM/a test meaningless.
Two small studies supporting Gillis’ theory have been conducted, both of them financed by EpicGenetics. The most recent study, published in Rheumatology International, compared the blood profiles of 160 patients who had taken the FM/a test to blood from hundreds of lupus and rheumatoid arthritis patients, as well as a control group.
“We were able to demonstrate statistically significant differences in scores comparing patients with FM (fibromyalgia), healthy controls and autoimmune disease,” wrote lead author Daniel Wallace, MD, a rheumatologist at the Cedars-Sinai Medical Center in Los Angeles and a professor at the David Geffen School of Medicine at UCLA who has worked as a consultant for EpicGenetics.
“This cytokine profile test had a 93% sensitivity and an 89.4% specificity for the diagnosis of FM. We also found that these profiles are relatively sensitive and specific for FM compared to SLE (lupus) and RA (rheumatoid arthritis). It remains unclear if these differences are directly related to the pathogenesis of FM.”
Wallace called his research “exploratory” and said further studies are needed to see if other autoimmune diseases can lower levels of chemokines and cytokines in the blood.
But Gillis goes further – saying the study “proved” that the FM/a test works.
“This study analyzed patients with fibromyalgia against patients with rheumatoid arthritis and lupus, the two primary illnesses in rheumatology. And it proved that our biomarkers are indeed distinct for fibromyalgia,” said Gillis.
"Junk Science"
But critics say more proof is needed – not only that the FM/a test works – but that fibromyalgia is a separate and distinct disease.
“The study is interesting but interpretation of their results is still made somewhat difficult by the fact that, as far as we know, fibromyalgia is not a discrete medical condition,” said John Quintner, MD, a rheumatologist in Australia.
Quintner calls fibromyalgia a “symptom cluster” and says lower levels of chemokines and cytokines could be caused by a number of different disorders that trigger an immune system response.
“Such conditions might also include major depressive disorder and post-traumatic stress disorder,” Quintner wrote in an email to Pain News Network.
An even bigger skeptic is Fred Wolfe, MD, a prominent researcher and rheumatologist who has called the EpicGenetic studies “junk science.”
“The (new) study is very, very bad, and does not meet minimal scientific standards. The test is not needed and could not possibly be valid,” said Wolfe, who also considers fibromyalgia more of a symptom than a disease.
“What you need to do in a study like this is you need to have an unbiased population. And this is by no means an unbiased population. They picked the people. If you’re measuring stress, it’s very easy to pick the patients you want and get the results you want,” Wolfe told Pain News Network.
“Fibromyalgia is an illness that can be found in people with rheumatoid arthritis and lupus. It occurs in about 25% of people with rheumatoid arthritis. It’s sort of like separating anxiety from cancer. A lot of people with cancer have anxiety. And the idea that you could have a test that separates anxiety from cancer is absurd because these conditions can occur together and frequently do.”
Pfizer Funding
Gillis says Wolfe’s views about fibromyalgia may have been influenced by funding he received from Pfizer, a pharmaceutical company that makes Lyrica – an anti-seizure drug that was re-purposed by Pfizer to treat fibromyalgia. Lyrica is Pfizer’s top selling drug with annual worldwide sales of over $5 billion.
According to ProPublica, Wolfe received $200,000 in funding from Pfizer from 2010 to 2013 for research and consulting.
“Our test says that fibromyalgia is an immunologic disorder,” said Gillis. “Why would you take an anti-seizure medicine for an immunologic disorder? Lyrica’s primary indication is for anti-seizure therapy.”
Wolfe says the funding he received from Pfizer was for a rheumatoid arthritis study, not fibromyalgia. As for Lyrica, Wolfe says he doesn’t consider the drug a good treatment for fibromyalgia.
“I think what Pfizer has done has been very harmful, and I have stated and written this publicly. I was barred from speaking at a meeting some years ago by Pfizer and have continuously refused to cooperate with them,” he said.
