Blue Cross Blue Shield of Illinois coverage policy for partial-breast radiation therapy to be reviewed

Sep 18 2006

Blue Cross Blue Shield of Illinois' policy that it does not cover partial-breast radiation therapy was scheduled to be reviewed last Wednesday in Dallas during a three-day meeting of Health Care Service Corporation officials, the Chicago Sun-Times reports.

The procedure, known as MammoSite, uses an approach called brachytherapy -- an internal treatment in which an inflatable balloon is surgically inserted into the breast.

A thin tube is attached to the balloon and for 10 minutes two times a day a radioactive seed is inserted into the balloon that fills the tumor cavity.

The treatment takes an average of five days to complete, the Sun-Times reports. FDA in 2002 approved the procedure, which costs about $2,500 more than standard radiation therapy, but the agency warns that the device has not been proven in clinical trials to replace standard radiation therapy.

Blue Cross Blue Shield health plans in other states and some other health plans do cover the treatment, according to the Sun-Times. BCBS of Illinois Chief Medical Officer Stan Borg in a statement said that the therapy's use as a first-line treatment is "currently in clinical trials, and we regularly review our medical policies to include updated scientific information" (Rackl, Chicago Sun-Times, 9/13).