Which Medicare Part D Drug Plan are you Choosing for 2019 and Why?
There are probably only a few good ones for those of us who are, or who may in the near future, be taking expensive prostate cancer medications like Zytiga.
OK here is what I have found so far.
I went on Medicare and put the following drug list in (you really can't predict at the start of the year what you might be on at the end of the year, so I put everything in). The least cost per year plan was "Express Scripts Medicare - Saver (PDP) (S5660-233)".
Express Scripts included all of the drugs in the formulary and imposed no step therapy requirements... which is a good start.
They all require prior authorizations. That's OK I guess. The last three have quantity limits. That is probably OK for most patients.
Erleada TAB 60MGTier 5: Specialty Tier Y
Firmagon INJ 120MGTier 4: Non-Preferred Drug
Lupron Depot (3-Month) INJ 22.5MGTier 5: Specialty Tier
Xtandi CAP 40MGTier 4: Non-Preferred Drug
Yonsa TAB 125MGTier 5: Specialty Tier
Zytiga TAB 250MGTier 4: Non-Preferred Drug
Express Scripts Total Out of Pocket Cost per Year is $19,618 (that is if you are taking all of them at the same time)
Next in line are:
Mutual of Omaha Rx Value (PDP) (S7126-049-0) Annual: $19,710
Mutual of Omaha Rx Plus (PDP) (S7126-016-0) Annual: $19,801
Express Scripts Medicare - Value (PDP) (S5660-119-0) Annual: $20,022
My current plan (which used to be the lowest cost for this combination) is Aetna Medicare Rx Select (PDP) (S5810-291-0). It has now jumped to Annual: $92,975. Most likely as a result of its recent merger acquisition.
I did learn that no matter what you do, advantage plan or not, they are going to charge you up to 5% copay even after the donut hole. No matter where you run, where you hide you are going to have to pay that 5% on these expensive cancer drugs.