Thyrogen (Thyrotropin Alfa)

Aetna covers Thyrogen (thyrotropin alfa) for thyroglobulin testing and radioiodine imaging as an alternative to thyroid‑hormone withdrawal only for patients who cannot undergo withdrawal for medical reasons, are unwilling to withdraw and whose physician accepts a less‑sensitive test, are unable to mount an adequate endogenous TSH response, or would otherwise be evaluated solely with serum Tg without withdrawal. It is considered experimental/investigational for all other indications (e.g., suppressed Tg <0.1 ng/mL) and Aetna notes limitations including lower/noncorrelating Tg levels versus withdrawal, risk of missed/underestimated disease, anti‑Tg antibody interference, and unknown impact on recurrence >5 years post‑ablation.

"For adjunctive use in non-toxic multinodular goiter: documentation that Thyrogen is being used as an adjunct to radioiodine ablation."

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