OPTUNE TTF v Insurance

[Dex2010]

hi community.

we live in the UK, my husband has stage 4 GBM-methylated, and are fighting our insurance company (not sure if I can name, but they begin with a V) to fund Optune TTF from out “premium cancer care policy”. However, they are refusing as it’s not NICE approved, even though they fund other non licensed cancer treatments. 2 other major uk insurers fund it.

The safety and efficacy of Optune Therapy has been assessed in accordance with the law by an independent, accredited Notified Body and has been certified with a CE mark following this conformity assessment. It has therefore surpassed the necessary regulatory threshold demonstrating that the product is safe and effective in treating my condition and can be made available to patients like my husbands.

MY QUESTION TO THIS LOVELY GROUP…

1) Has anyone come up against this with their insurance?

2) what was been the outcome

3) any tips for success

4) any other legal routes u can take life financial ombudsman and tip’s on how I should approach

thank you so much

[Maddie_TBTC Administrator]

Hi there, thank you for reaching out to the group. I am sorry to hear about the difficult situation you are navigating. It sounds like you have already been pro-active and doing all you can in response to the current circumstances.

May I ask, have you spoken to your husband's medical team that you are trying to access Optune? They may be able to help put a case forward to your insurance company.

In terms of dealing with the financial ombudsman, I'd suggest reaching out to your local citizens advice, as they will have expert advisers who might be able to provide some advice around your next steps.

Finally, I wondered if you were a member of our online support groups on Facebook? The subject of Optune gets discussed from time to time, so you may be able to find others who have been through a similar situation. This group in particular comes to mind: facebook.com/groups/thebrai... but you can find information about our other groups through this webpage: thebraintumourcharity.org/l...

I'm sorry I wasn't directly able to answer your questions, but I hope these links provides some use.

Warm wishes,

The Support Team

[Dex2010 in reply to Maddie_TBTC]

Thank you. Yes we are working closely with our oncology team and with novocure who manufacture the device. It’s a tough one as other insurance companies fully fund it but not mine. I will look at the FB group also.

Thanks for your response

Dex

[Cedarmarie Community Champion]

Hello, no relevant experience to help but just wanted to wish you well! I hope you manage to make progress.