Diagnosed in 2000 at age 61. PSA 5.6. Radical retropubic prostatectomy. Detectable PSA 18 months post surgery. Salvage radiation 2003. PSA has continued to rise almost continuously to current level – 197.8. Have been on Lupron + Casodex for a while, then Lupron + Nilandron (nilutamide), then Lupron only since 2012. “Mass” in retropertineum first detected in 2012. Has continued to enlarge slowly until its present size of 3.8cm x 5.1 cm. Biopsy March 11, 2016, confirmed the “mass” is PCa. Doctor at Memorial Sloan-Kettering Cancer Center recommends beginning Xtandi. Other than the PCa my health is very good. The only way I know I have PCa is the rising PSA and “mass” revealed by CT.
I am on Medicare plus BC/BS supplemental. I know that Xtandi is very expensive. My question is what is the experience of members of this group in regard to insurance paying for Xtandi?
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Davisjl
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Whether your Medicare includes Plan D or not, and not sure if BC/BS includes backup coverage for Plan D expenses, you should probably contact Xtandi at the following to determine if they provide financial support:
I have been taking Xtandi for 6 months. Have Medicare and Humana drug coverage. Xtandi "retails" for about $9000/month. I also take several other high cost oncology drugs, so I blow through first 3 levels of drug coverage in first 2 months of the year and then pay for Xtandi at 5% of the $9000 price. Your cost will depend on your drug plan and the costs of anything else you might be taking. Best wishes.
Hi Davisjl, I'm currently on Xtandi, Elagard & Celebrex. The cost of Xtandi is very concerning. I was able to get into an assistance program that really helped us out. My doctors office found it for me because I told them straight up I couldn't even afford my deductible. The card I have doesn't give a whole lot of information but it looks like the program is through McKESSON and the phone number on the back of the card is (855) 834-3465. It basically leaves you with a $20 co-pay. I'm not sure but I think you have to go through your doctors office to get it set up. But I would definitely call the number and check it out. It's made being on this crazy expensive drug doable. Good luck friend.
You didn't mention if you had tried Avadart, estradiol, or other secondary harmonal therapys. I would be surprised if you haven't. I was on estradiol patches for 10 years before Xtandi. Also contact the Patient Access Network ( PAN ) regarding assistance with Xtandi prescription costs. My Drs office got me an $11,000, one year grant that when combined with my Part B supplement resulted in me paying nothing for a year of Xtandi. As a bonus although I didn't pay anything for the Xtandi the cost did go against my total out of pocket Part B costs quickly getting me through the donuts hole and thus reducing all my prescription costs. PANs number is 866-316-7263. Good luck.
There is a trial starting with Eli Lilly Pharmaceuticals using a drug that is in Phase II. You get the Lily drug or a placebo plus xtandi. While you are in trial the Patient Access Network Foundation will pay for the xtandi.
The pan foundation can offer enough financial assistance to bring your cost down to zero if you qualify. Qualifying is pretty easy and can be done at panfoundation.org or via phone. The number is on the website.
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