Zytiga

[Andrika]

Does anybody know if Zytiga is covered under Medicare

[ggbk]

It is but the copays are very high, and I guess it depends on what drug coverage you have. Message me if you would like more details. George

[Andrika in reply to ggbk]

Not sure how to go message you from here

[Hidden]

Yes, it is covered if the cancer is metastatic.

[Andrika in reply to Hidden]

Would you know what the cost might be. I’ve heard $1500.00 a month

[Hidden in reply to Andrika]

Here they explain:

goodrx.com/zytiga/medicare-...

[Andrika in reply to Hidden]

My concern is even though I’m 72 years old, I’m still employed and have insurance coverage from my company. When I sign up for Zytiga they told me I could not use any other way to pay for the drug. So now after 3 months on the drug I’ve decided to retire and I’m concerned about what will happen with my co-pay.

[Hidden in reply to Andrika]

I think it depends if you have a pension plan or not. If you have a pension plan it may include an insurance which in general complements Medicare. If you retire and you do not have a pension plan I believe you will be 100% responsible for paying the co-payments required by Medicare.

[pkafka]

There is strong rumor that Zytiga will be going "generic" sometime this year so we will be able to access Aberatirone at a much more afordable cost. When that will be I don't know.

[RLSharp in reply to pkafka]

See this link: fiercepharma.com/legal/j-j-...

Generic Zytiga may be available this October.

Richard

[TommyTV]

When I read posts like this, it saddens me you have no national healthcare like the rest of the civilised world. How the hell has this happened? Why do you stand for it? Our NHS pays for our drugs, and they always force the drug price down as they are a large buyer, just like a supermarket chain. You will never drive prices down whilst insurance companies are paying on an individual basis.

Good luck with the Zytiga though, it’s a great drug.

Martin

[mlabrams54 in reply to TommyTV]

Please, no politics.

[pjoshea13 in reply to TommyTV]

But Martin, the NHS initially refused to pay for Xtandi. Later, when J&J lowered the price, they allowed it for mCRPC cases that had failed chemo. More recently, they have added that Zytiga must be used first.

In the U.S., men aged 65 & up are covered by Medicare, which is somewhat more flexible.

-Patrick

[vandy69]

Good Morning Andrika,

I started Zytiga with Prednisone in 1/13 just as it was FDA approved prechemo. At the time I was 65, retired, and my previous employer provided a commercial drug plan so I could use a Zytiga coupon for very minimal monthly cost.

Later my previous employer cancelled our commercial drug plan and I enrolled in a Humana WalMart Medicare Plan F supplemental drug plan. Once I blew through the deductible, easy to do with Zytiga retailing for $10,000/month, my copay was 5%.

Humana has been wonderful for me--retail drug costs for me in 2016 were $312,000, but my copay was $20,000. My previous employer has a catastrophic drug plan which reimbursed me for every out of pocket dollar over $5000. Monthly Humana premiums were about $18.00/month. Worked extraordinarily well for me.

Best wishes. Never Give In.

Mark, Atlanta

[TommyTV in reply to vandy69]

Hi Mark, the retail price in the UK for Zytiga is £2840 per month. If it’s $10,000 in the USA, that’s profiteering on a massive scale. They should be ashamed of themselves.

[mklc in reply to TommyTV]

In Canada, Zytiga costs CA $10,000.00 a month!!

[TommyTV in reply to mklc]

So exactly the same drug, which costs exactly the same amount to manufacture, cost 3x as much. That’s an absolute disgrace.

I’m setting up an online Zytiga store and only charging twice as much. I’ll by happy, you’ll be happy, and the drug company can go f*ck themselves.🤓

[Break60]

It is and the donut hole is slowly closing so copay is coming down and when you reach the out of pocket max which you will quickly your copay is low! Good news

Bob

[Gary94]

Glad I’m not in the insurance game. My co-pay for zytiga (when I was taking it) was $11.00. I’m in the VA health care system.

[Magnus1964]

It is covered under part D of Medicare but the copays are very high. Check with your doctor or the company itself. They may be able to help with costs.

[Poscan4]

I am on Zytiga and the monthly cost is $9,000.00 a month. My part D drug ins. covers most of it. But due to a divorce that about wiped me out I have Medical assistance to help me with the costs.

[Andrika in reply to Poscan4]

Which insurance did you go with

[Andrika]

Are you talking about Medicaid or Medicare