My experience in getting an Xtandi perscription

My oncologist recommended I go on Xtandi. It took a bit of work getting it at a cost I could afford.

My Medicare PartD provider approved Xtandi. I received a call from the specialty pharmacy with the cost. Due to the "donut hole", the first month was $2700; the next eleven "only" $500. That's pretty stiff when you're on Social Security.

My patient navigator found out about a manufacturer's program that would mostly pay for the drugs. We had a 3-way call, I was accepted, and I got the drug. Here's some tips that may help you:

1) Your income must be less than $64,000 a year. You must submit proof (IRS 1040).

2) Unfortunately, you'll have to deal with people who don't understand or are not aware of the program. Be prepared to educate them (nicely).

3) You'll also find that the left hand doesn't know what the right hand is doing. For example, I had people calling me to submit forms after I had already been approved.

4) When you find the right people, keep a record of their phone numbers. I've found that calling the right people will help you get things done quickly.

5) This is strange. I was dealing with CVS Specialty Pharmacy. I started getting a lot of calls from a specialty pharmacy in Florida (twice a day). They said they were associated with CVS and wanted all of my information. One day when I was on a call with CVS, I asked if the FL pharmacy was associated with them. CVS said yes, so I asked them why they kept calling for my information. I was put on hold for a few minutes. When the CVS rep came back on the line, she told me to BLOCK their calls. So be sure you know who you are giving your info to.

Bottom line is that I pay my $600 annual co-paid at the beginning of the year, and I get the rest of the year free.

Start with Xtandi Customer Service at 855 898-2634. Be persistent. It also helps if you have a great patient navigator like I do.

Good luck!

5 Replies

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  • Thanks for all this helpful information. Perhaps you could post again sometime in the future to let us know how effective Xtandi is for you?

  • I agree with Steve, please post your experience with Xtandi.

    My insurance denied Xtandi, but approved Zytiga. My PSA went from 29 to 1 in just two months. And my T is at 0%. I haven't had any side effects that I'm aware of, other than the usual ADT stuff.

    Joe

  • I will post my experience. Have to ask the doc to test my T level.

  • What insurance do you have?

  • Medicare and Symphonix for Plan D.

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