ZYTIGA (abiraterone) "is now generic and is available in USA for $2400 a month, In Europe for $500 to $ 700 a month and in India for $150 to $200 a month." LearnAll
Does anyone have any workable strategies for obtaining low cost ZYTIGA (abiraterone) from outside the US? At these costs it seems like it could make sense to take a long vacation overseas to reduce prescription costs.
Maybe even staying a month at a time and buying 3 months of medications. Then rinse and repeat.
Any ideas anyone?
If you need a well respected oncologist in Delhi my oncologist there is Dr. Ashok Vaid at Medanta Medicity. Never have priced Zytiga b4 but not surprised since Firmagon is about $300.00 a syringe.
Hmmm. Learnall said is costs, in India, "$150 to $200 a month." It can't cost all that much to fly to India.
Anyone have any actual experience on Zytiga cost in India?
The so-called original Zytiga is available in Bombay at INR 120,000/- or US$ 1715/- for 120 tablets (30 days supply). I have not used this, thus far.
Hmmm according to GoodRx you can get generic abiraterone for $1,922 in the US at Costco. That's 120 pills of 250mg each.
My understanding is that that Jannsen Pharmaceuticals still has the US patent which doesn't expire until 2027, and has exclusive rights to sell abiraterone in the US until 2021. I think their protection still holds in the US, Canada & Europe.
Especially in India, I would want to get the real branded Zytiga.
But there are hugely large differences in pricing, even just going across the border to Canada, let alone India.
Though you really need to be careful about getting counterfeit drugs.
Unfortunately, India makes a lot of official branded product for US Pharmas. And they just don't seem to care about quality. A real problem with even branded non-counterfeit medications.
You are right--2027--but does not prevent generics:
accessdata.fda.gov/drugsatf...
Fish
I'm not a lawyer, but from what I followed, the district court invalidated Janssen's patent because it was "obvious" (because its language included prednisone with it), but Janssen is appealing. The district court further said that if the patent is upheld on appeal, anyone selling a generic in the interim will be in violation. The FDA has approved several generics as safe and effective but did not grant rights to market pending the appeal decision.
That case in US federal court would only apply to US patents.
Most western countries respect US patents
Ahhh! Finally something I am more knowledgeable than you Allen. LOL
Patents are nation specific. They start and stop at the border. Each nation has sole and exclusive jurisdiction over patent rights within it's borders.
If you want a Japanese patent, you hire a Japanese firm to file it in Japanese, and enforce it in Japanese courts, in the Japanese language.
Those big Pharmas spend lots filing patents all over the world.
My understanding is that Janssen's patents are recognized by all western countries - is that incorrect?
jnj.com/court-issues-ruling...
I thought that there are worldwide intellectual property laws, no?
No. It is not correct. As a practical matter, any pharma will file patents in North America, EU, and Japan, for the same drug, invention or process.
So it might seem that way.
But the only government who can grant exclusive monopoly rights in Japan is Japan.
And the only government who can do so in the US, is the US. Trademark rights operate similarly as well.
There are treaties that sort of keep all the countries sort of on the same page, but not really.
For example, the US is the only country that will issue a patent for software.
Each country pretty much jealously guards its own perogatives.
But getting back to Zytiga. I assume Janssen has patent protection in most of the world. It sounds like Janssen isn't in danger of losing their patent protection anywhere else but in the US.
Yes. All that is at risk in the US is likely just US patents... Unless there is also some related contract dispute.
But on a dollar basis US might be half their market. The US market is the tail that wags the dog when it comes to pharmaceuticals.
One of the generics available now is from Patriot Pharmaceuticals, a wholly owned subsidiary of Janssen. My insurance company requires a generic now and CVS Specialty told me they are using Patriot.
"Patriot Pharmaceuticals"
1. What are they charging?
2. What a shameful name. We are supposed to be patriotic if we overpay a greedy US based company selling pharmaceuticals manufactured with cheap Indian labor? LOL
My copay for the generic is 160 for a month supply. This is with Medicare Part D once the donut hole has been satisfied.
Who do you have your part d wth
It's country by country, but protection at the borders is pretty good.
Janssen lost their Zytiga patent protection thanks to Mr. Trump.
It had nothing to do with Trump. Their patent lawyer should be fired, imo, although I'm glad of the result.
You could look here....
dir.indiamart.com/search.mp...
You can send requests for prices on different ones....The Samtica was listed at 10,000 rupees or $147.00 for a one month supply...you can ask prices for real Zytiga... someone here is taking 500 mg a day and eating yogurt and their results have been good to save a few more dollars
There are several online sites--could contact Learnall and see if this is a good company...
Good luck,
Fish
Angad Pharmaceuticals (Samtica) is Delhi based and not as reputed as Cipla Ltd of Bombay (Mumbai). Cipla ltd sells Xbira and Zecyte, generic versions of Abiraterone.
I take Zecyte.
You mentioned that the original exported Zytiga from US is INR 120,000/-
Whats the price for the similar dose for Xbira or Zecyte? I think approx INR 20,000 +
Thats a really huge difference especially when we may have to use it for months/years (as long as it works).
What are your thoughts on the quality/effectiveness difference between the US imported and the Indian ones? Although its not possible for us to determine it accurately since we have never used both to compare.
Exactly. Since I have never used the original, I cannot compare it with the Indian one. The Indian generic version of Abiraterone has been useless for me thus far.
But, I know of others for whom it has been successful. Very very successful. Almost 3 years with generic Abira and their PSA still undetectable. Lucky guys.
So its your call. I just cannot say anything.
Zecyte cost me Rs.11,000/ for 120 tablets. I haven't tried Xbira as yet.
My understanding is that India is not a signatory to international treaty on drug patents.
The argument is that their 1.3 billion population are not rich enough to afford expensive medicines. As of now, they have not signed the treaty in spite of very high pressure. That's why one pill of Viagra is 10 cents and one pill of Prozac is 2 cents in that country. How to get it. I do not know.
Those prices on india mart which you showed comes to $150-$200 a month for zytiga ….One dollar buys 70 Indian Rupees.
Seems like there are some quality issues here.
Does anyone know what the Canadian and EU pricing is?
I am a little disappointed that no one here seems to have found a workaround on sourcing low cost Zytiga. If anyone has done it, it would be someone here, you would think.
I just went here:
canadapharmacyonline.com/Dr...
And they are charging $4199.00 For 120 pills of Zytiga and $959.00 for 120 pills of an Indian manufactured generic version
The GoodRx Costco pricing of about $2000 looks pretty good in comparison.
Something seems off here?
Hello Cesanon,
My apologies in advance for this reply as I can't recall enough details to make this useful but wanted to mention it just in case. I know this doesn't directly answer your question but thought there was chance it might help. When my Dad was prescribed Zytiga at our first visit to the Univ of Chicago I recall them stating that if the cost / co-pay was too high (For some it could be many hundreds/thousands of dollars a month) that there was a special program you could enroll in which would cover most of the co-pay. [This program was not a loan/financing and I believe they mentioned that in some cases it could reduced payments many hundreds of dollars a month to 10's of dollars a month]. This is from their specialty pharmacy "We will help enroll you in financial assistance programs to help with co-payments, and make sure there are no financial barriers to starting your medication. These programs include discount coupons from drug manufacturers and assistance from various disease management foundations. " uchicagomedicine.org/patien...
I believe North Western University in Chicago has similar programs.
In India with such an expensive drug I would recommend buying it from a private pay hospital. Their reputation depends on it. Medanta Medicty where I go accepts appx 20,000 international patients a year. Fortis is up there too along with others. The prices are in line with street pharmacies. Guardian Pharmacy for instance is at Medanta, Delhi Airport etc. There are definitely some pharmacies there I would stay away from when there are good ones. They may be fine, but why take a chance when it comes to your life.
Cipla, a large and respected Indian pharmaceutical company makes Abiraterone Acetate (Zytiga) under the name of Xbira and Zecyte which is available in India from mail-order pharmacies for $250 - $400 for a months supply..
geneteclifesciences.com/xbira/
netmeds.com/prescriptions/x...
Yes...its true...CIPLA is one of the most reputed large Indian drug company in existence for at least last 75 years.
Cipla is good. So is Glenmark.
However, both have received FDA warning letters. Both say that the infringements are minor and that they are working to correct them.
hmmm that's interesting.
But the FDA doesn't have jurisdiction in India. It has jurisdiction only to the extent that Cipla or Glenmark elect to market their wares in the US. Which it seems that they are not currently doing, as their brands do not appear to be available in the US.
And it seems people are not buying directly from Cipla, but through third parties.
But it sure would be nice if they started selling into the US. Or if they are about to do so.
If you have any links explaining what is doing on with the FDA and Cipla/Glenmark would you please post the link. If we could buy their drugs safely in the US, at a low cost, we would all be interested in it.
Both Cipla and Glenmark are exporting generics to the USA. The FDA has the power to shut down these exports and cripple these companies. So far, nothing of the kind has happened or frankly, imho, likely to happen wrt Cipla or Glenmark.
The book "Bottle of Lies" by Katherine Eban (available on Amazon) gives one a fairly good idea of what is going on. Definitely worth reading, especially if one is investing in shares, like I am.
1. Oh, so you can buy them today? But not under their Indian brand names?
2. How do you go about buying them, today, in the USA?
3. At what kind of prices?
I do not know the answer to any of your three questions as I live in Bombay, India and not in the US of A.
Both, Cipla and Glenmark are exporting "generics" to the US as of today. Whether they are exporting the generic versions of prostate cancer drugs or not, I do not know.
Well thanks a lot for what you know.
My husband took Zytiga for his first month on this medication at an insurance co-pay of $2328.25. The second month he took the generic, abiraterone acetate, purchased in India. Three bottles were $260 a piece, the next four were $320 a bottle, supposedly due to an added government tax. We talked with Mr. Singh in New Delhi, India, and completed our entire order through WhatsApp. Our shipment arrived at our front door in five days. Mr. Singh answers his phone and sends and receives text messages day and night. Contact information: EMEDKIT, Mr. Singh, phone number +919811604429. Medication info: abiraterone acetate tablets, 250 mg., 120 tablets. Manufactured in India by: Glenmark Pharmaceuticals Ltd. and approved by USFDA. Another participant on this blog replied to me that Glenmark has been in business for 30 years and is approved by USFDA. Our connection to this supplier was passed on to us through our oncologist. We wired $2,096 to Mr. Singh’s company and had constant contact with him from purchase through tracking to our front door. The shipping fee is $36.00. We ordered enough to last through the end of December. I know, a little risky to assume that the drug will continue to work for six months. Positive thinking! Two months ago, my husband’s PSA score was 233. July 1, PSA 0.77.
Coco2535
Thank you for that information. May I ask in what country you are located. I am in the US and we have some funny laws about buying controlled products from other countries.
We live in the US in California. The medication went through customs in SF, fulling labeled as to what it was and for what purpose. No hitch there! We forwarded a copy of the prescription to Mr. Singh at EMEDKIT, although they did not require one. Zytiga is $10,000 for a one month supply in the US. We are covered by Medicare with a Medicare supplemental policy through Blue Shield of California. Medicare and Blue Shield each paid a portion of the cost, leaving us with a co-pay of $2038.25 to be paid out of our pocket every month. We applied for financial assistance through Johnson & Johnson. We did not qualify.
Thank you. This is something to keep in mind for other drugs. I have already been in a zytiga trial and after 3 1/2 years failed.
You got 3 1/2 years on zytiga? Isn’t that considered a very long time? Wow!
Yes, I was on a drug trial with zytiga and ended up being the last man standing in the trial.
Wow! You were lucky! Did you have chemo first? Does the trial indicate any way to get longer use of zytiga?
The trial was to get FDA approval to use zytiga before chemotherapy. At that time it was only approved for use after chemotherapy.
Coco look at plan 65 with blue cross. Mine is 2300 to the donut then 325 for Zytiga and 230 for Mylan generic. How’s the earthquake treating you?
"Coco look at plan 65 with blue cross. Mine is 2300 to the donut then 325 for Zytiga and 230 for Mylan generic."
Carlo, can you explain that using more words?
My blue cross plan is for those over 65 called plan 65. The plan D part covers Zytiga or the generic at a cost of 325 or 225 for the generic after the donut hole cost the first of every year. You can change your part D every year at the time it is open. Hope this helps.
Thank you! Good information! We will look into Plan 65 with Blue Cross. It sounds like a good plan for us.
"Two months ago, my husband’s PSA score was 233. July 1, PSA 0.77."
You know there is a case to be made for intermittent treatment. Continuous use may dull its effectiveness and turn you castrate resistant sooner than otherwise.
What does your oncologist say about that?
I’ve never explained my husband’s journey with Advanced Prostate Cancer to date, so here it is. My husband is 86 years old. In November we moved from our home of 18 years to a condo. We needed to go through an extreme clean out of collected stuff after 60 years of marriage. My husband is a graphic designer by trade and had never had to dump anything before this move. The stress was devastating. As soon as we moved, he had constant back pain, heavy fatigue, couldn’t lift his right leg, pain in his right hip and some incontinence with both urinary and bowel control.The PCP took x-rays, a bone density scan and an MRI. She pronounced him suffering from osteoporosis, osteopenia, scoliosis, healed broken ribs and squashed discs at T10, T2,T3 and T4. He was told that all of his symptoms were coming from deterioration in the spinal area, and to go home and take Ibuprofen for the pain. A third-year residence wasn’t satisfied with this diagnosis and sent him to see a urologist. After a digital rectal exam, the urologist told him that he felt something that shouldn’t be there. He ordered a PSA blood test which showed a PSA score of 233. Following that, the urologist ordered a colonoscopy, rectal biopsy, nuclear medicine full body scan, and took 10 prostate biopsies. In March his diagnosis was Advanced Prostate Cancer metastasized to the adrenal glands, six pelvic lymph nodes and the tip of the right femur. The rectal biopsy was benign. The ten core prostate biopsies were all cancer. The urologist gave him a six-month shot of Lupron and prescribed 30 days of Casodex. The MO put him on Zytiga and Prednisone, as well as a monthly infusion of Xgeva. All his symptoms have subsided, he is in his third month of treatment. I don’t mean he feels well all the time because he has the same side effects as many of you. I know it seems as though we shouldn’t ask for more at age 86 and with 61 years of marriage, but no one wants to lose a loved one to a debilitating and painful decease.
PS The medical protocol is to stop PSA tests at 75 years of age.
PPS I apologize for the text being so long, and for making a political comment. No harm meant, new to all of this and learning. Thanks for your advise and comments.
The medical protocol is to stop PSA tests at 75 years of age? Wow. My family doctor did better than that. Yearly physicals, 15 of them, and his medical protocol for PSA test were "0". I found out what a PSA test was 4 yrs into having prostate cancer. My symptoms were zero up to 6 months before being diagnosed at the age of 66. Frequent nightly urination was my only symptom 6 months before being diagnosed at the age of 66. A 3 day stay in the hospital saved my life and treatments started with a MO got me on my feet. PSA tests are cheap and should start at the age of 50, maybe sooner. Just my opinion, Lincolnj8
There were 2 guys 43 and 1 that was 50 years old doing radiation with me out of a group of 11. All three were Gleason 8. Like you said psa test is easy. Start at 40.
Agreed. The test is cheap and can save your life. I found out when my daughter took me to the ER and they gave me a room. She said my hemoglobin number that should have been around 13 was around 3. I was clinically dead. Lots of blood transfusions and a great MO brought me back. All this because of a PSA test that was never given. It's all about the money I guess.
I had 2 guys in my radiation group that were 83 going for 100. They were not listening to drs that stop checking psa at 75. One special guy said something I will never forget while we were discussing treatments. He said. Always choose life. He was 83.
Good luck with his treatments.
Always choose life. At 83. Good one. He wasn't ready to give up..
My provider issues generic Zytiga, I assume from India, but not certain. Everything is working so far, PSA .02
Thanks This is very helpful.
Looking at these prices and co-pay (whatever that is), I’m glad I live in the UK where everything is free. And yes, working people and their employers do pay National Insurance, but it covers everyone from cradle to grave, which is as it should be in a civilised nation.
What exactly is the problem with the US on this?
Probably the wrong site to bring this up, but I see lots of posts with this discussion of costs. I’ve always wondered what ‘co-pay’ is.
Anyone?
"What exactly is the problem with the US on this?"
My working hypothesis is that we have a lot of angry racists (white, older and disproportionately male) who don't want to directly or indirectly contribute to the welfare of these undeserving people.
So they are willing to permit the top 1 percent to rob them and their families blind in order to deny healthcare to these undeserving non-whites.
So everyone else here is getting the healthcare only these self absorbed ignoramuses deserve. They only represent 1/3 of voters, but coupled with campaign contributions and pac money from the 1 percent of the 1 percent, and recently a little help from Russia, we get what we have today.
MAGA
silverlinemedicarepvtltd@gmail.com
Whatsapp +919021240078
I ordered 4 month supply for $610 delivered to my door. They arrived in 10 days. The drugs come from Glenmark Pharmaceuticals in India, brand name Abirapro.
Glenmark is a solid drug manufacturer, established in 1977 for the specific purpose of making generic drugs.
I have used Abirapro but have switched to Zecyte as Cipla is more reputed than Glenmark is. However, Glenmark is also good, no question.
The price that you got Abirapro for is exceedingly good considering that shipment from India to the US was involved. I paid US$ 200/- for 120 tablets in Bombay. You paid US$ 152.50 for 120 tablets including shipment from India to the US. Well done !!
This is the link for the Janssen (Zytiga patent holder) CarePath program..cost is $10 per month for those with commercial/private insurance. Sorry US only...will be trying this in a couple of weeks after my first Firmagon shot is done...going to Lupron after that...
janssencarepath.com/patient...
Will report back with how the process worked.
"Eligible patients pay $10 per month, with a $12,000 maximum program benefit per calendar year or one-year supply, whichever comes first. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications. Terms expire at the end of each calendar year and may change. Offer not valid in CA or MA or for MA residents (250 mg tablet only). There is no income requirement."
"Not valid for patients using Medicare"
Maybe not so useful for many of us.
Cesanon are you on Medicare with a supplement from an insurance company that doesn’t cover Zytiga? Blue cross has a plan that costs 225 a month after the donut hole of about 2300 for the generic. Not cheap but close to what you are saying about the cost in India. If you are under 65 please disregard. I doubt the cost of the drug would be more but the policy would be a bunch more. I know I’m still paying for my young wife for a couple more years.
As for Big Pharma, greed knows no boundaries. What compromises so many of us is that our investments in mutual funds that feed our retirement income include some holdings in Pfizer, etc.
MHUNPA....
Make Health Unlocked Nonpolitical Again.
Stop with the Bullshit!!! Or I'll become an angry old white male racist....Geezamacripe.
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 07/07/2019 7:55 PM DST
PLEASE NO POLITICS.....
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 07/07/2019 9:20 PM DST
100% agree with you, j-o-h-n.
Lets hope better sense prevails. Cheers !!
OK, but what’s CoPay?
I do not have any INSURANCE, but to the best of my knowledge and in this context, CoPay is an insurance term which means that both you and your insurance company pay for the drug/treatment. Not just the insurance company alone.
I had my radiation at md Anderson in Houston Texas. There were guys and gals from all over the world. You would be welcome. My dr spoke 4 or 5 different languages.
"My only setback is that I don’t have a suitcase full of cash to seek higher quality treatment in the US."
That is a problem faced by many Americans. Until Obamacare, most bankruptcies in the US were medically related.
It is still a problem because of onerous copays, but still not as bad as before.
1. The US system is available to all who can afford it. Also, there are many people from outside the US who purchase insurance that specifically include US healthcare. Many in the US are blocked from it's benefits much as you are, yet don't have the option to take advantage of the Canadian system in the manner that you can. (The grass always looks greener)
2. Check with Tall Allen, but I think he has mentioned research that indicates that these two treatments together generate no improvement in results, but do generate additional side effects.
3. I think you might find it difficult to get any Doc in either the US or Canada to order a concurrent treatment of both Zytiga and Xtandi if my recollection of what Tall Allen said is correct.
Oh you mean that once you pick one, Zytiga or Xtandi, you have to stick with it for the duration?
That Sucks.
Though, as a result of info unearthed here, it seems that it is possible for you to switch to Indian sourced substitutes at a cost less than you would have to pay as copays in the US, even if it were covered by US insurance.
Is that a workable solution for you ITCandy?
ITCandy, In the US administered portions of the US healthcare system, such as the Medicare program, we have a fairly effective appeal process administered by independent decision makers.
As long as you can get a Doc to back you, and you have a substantive basis to appeal or request an exception to a rule like that, you can get it.
Do you have anything like that in Canada?
I’m grateful for the practical information sprinkled here. We’re all trying to survive and all subject to so many layers of discrimination and/or price-gouging on what, according to my oncologist, is a drug with an extremely simple molecular structure that is easy to manufacture. I’ve been on Zytiga and two of its generics for 2 years with amazing results so far...and w a wonderfully low co-pay. I lost my job last week and am now entering very uncertain insurance waters. Thanks for all these options, guys.
Lucky for me all my drugs are subsidized, my ADT (Dipherline) is 49 Euros for 3 month shot, my Morphine (Sevredol 60 tablets) is 49 cents. I'm very grateful for this, takes some worry arrow from an already stressful situation.
.. cash-only pharmacies charge ~$300 for 3 months of Zytiga. Scriptco. Cost Plus. For 2. I'm not sure if you need to be USA-based -- ask them. Good luck
Cost of abiraterone acetate
Zytiga is slowlyletting us down
Zytiga combined with breakfast lowers cost of treatment to one fourth
