How Do I Request OncoAct?
OncoAct can only be requested by a treating physician in a hospital. Before tumor tissue and blood can be transported, a Service Agreement must be signed. The logistics should be coordinated with the hospital’s pathology department and the hospital’s clinical chemical laboratory.
Service Agreement
To perform the OncoAct WGS test (receiving, processing, and analyzing the material, and reporting the results), an agreement between the hospital and Hartwig is required.
If you would like to know whether your hospital has already signed this agreement, or if you wish to arrange one, please contact us at info@oncoact.nl.
Inform the patient and if necessary request permission to store data
The treating physician:
Discusses possible outcome
Informing the patient and, if needed, requesting permission to store his or her analyzed data in the Hartwig Medical database for future research reuse. The patient’s choice can be communicated during tumor material registration or at a later time.
Transport of Tumor Tissue and Blood
The hospital registers the tumor material through the registration module in the online customer portal and can use the Hartwig collection kit to capture the tumor tissue and ship it on dry ice via a courier.
The hospital registers the blood sample using the form included in the Hartwig blood‑collection kit and returns it via the medical courier service. Instructions for collecting blood and tissue can be found in the order details for the collection kits and are also available online in the Hartwig customer portal.
Links for instructions for the use of portal:
Instructions portal registration module (in Dutch)
Instructions portal results module
DNA Analysis and Report
Hartwig Medical Foundation:
Begins processing tumor tissue and blood, performs the sequencing and analysis, and records the findings in an OncoAct WGS report.
Sends the OncoAct WGS report to the treating physician within 10 business days, if the tumor tissue and blood are of sufficient quality.
Would you like to know more about the extensive DNA test? Visit: How does OncoAct work?
Costs and Reimbursement
A fair price, not-for-profit
OncoAct Whole Genome Sequencing (WGS), an analysis of the tumor’s complete DNA, is performed by Hartwig Medical Foundation, a not-for-profit foundation. We make no profit on OncoAct WGS. The fee equals our cost price and covers only what is needed to perform the test at a high level of quality. We will gladly send you the current fee on request.
The price includes our part of the process: from receipt of the tumor tissue and blood through the compilation and sending of the report. It also includes the explanation of the findings by the clinical molecular biologist in pathology (KMBP), intended for the treating physician and the patient.
Tumor cell percentage
For optimal reliability of the bioinformatic analysis, a tumor cell percentage of at least 20% in the biopsy is required. If the percentage is lower but relevant findings are still made, you will receive an OncoAct WGS report marked “low purity analysis.” These findings may not be complete, but they can still be clinically relevant for the patient.
Reimbursement in the Netherlands
Each country has its own rules for the reimbursement of (molecular) diagnostic DNA tests, such as OncoAct WGS. In the Netherlands, OncoAct WGS is reimbursed on the basis of three sources: the KNT lists, the guideline on carcinoma of unknown primary, and the Care Pathway for Broad Molecular Diagnostics. The following patient groups are eligible:
- Patients with non-small cell lung cancer (NSCLC), from the indication for broad molecular diagnostics (from stage 1B adenocarcinoma);
- Patients with carcinoma of unknown primary (CUP), to aid in establishing the diagnosis;
- All patients with a solid, locally advanced or metastatic malignancy during the last line of systemic therapy. If only one line of systemic therapy is available for the tumor type, OncoAct WGS can be used immediately.
Registration and billing of WGS are done using the billing code ZA/MD 050548 (MD6), in accordance with the agreements with health insurers.
Please note: the fact that a broad molecular diagnostics test may be billed does not automatically mean that your hospital has agreements with the health insurers about it. Please check this in advance with your hospital’s contracting or finance department.
For patients: You can ask your health insurer and your healthcare provider whether the DNA test is (partially) reimbursed.
Requests through the treating physician
We perform OncoAct WGS only at the request of the treating physician. In doing so, we always enter into a services agreement with the healthcare institution. Together with the hospital, we ensure that the biopsy collection and the logistics within the hospital are handled carefully and that the chance of a usable result is as high as possible. This also ensures that the results are included in the patient’s record and are available for treatment and review.
OncoAct WGS is a collaboration with the hospital. The hospital determines the indication, collects the biopsy and blood, ships the material, and discusses the results in the multidisciplinary team meeting and with the patient. Hartwig performs the DNA-analysis, data analysis, and reporting.
Wanto to know more?
If, as the treating physician, you still have questions after reading the above, or would like to visit Hartwig, please send an email to info@oncoact.nl. Or call us by phone on working days at +31 (0)20 – 226 9700.
WGS offers the possibility to implement new biomarkers directly. This way you always have the most complete genomic analysis.