My MO was set to give me cabazitaxel with carboplatin as docetaxel was not working. However, insurance denied this treatment as not being beneficial. When MO asked for peer review the insurance doctor, who appears to know little about treatment of prostate cancer being specific to each individual, denied treatment. However, Radium 223 was approved. So that is where we are now. I guess cost wasn't in the insurance reps mind as Xofigo is 130k where chemo would be 20k.
My headstone will read "im here because insurance wouldn't let me have life saving treatment"
First injection done today, so far so good.
PS. got results back from Gardant. No biomass that would influence treatment.
Went to Oregon coast and waded in ocean....that soothed my soul for a bit.
Hope all is well with everyone and you are getting treatments that will let you live long and prosper (credit to Mr Spock🖖 )
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Maleko808
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They did pay for Gardant 360. It was the last appeal but we are working on a new plan where I may cover the carboplatin myself. Something in our back pocket for now. I see MO in two weeks and we will discuss Provence add on. He was doing his research on the combo. Thanks for the link.
No kidding. MyMO had some strong adjectives to describe the insurance doctor, and none of them were flattering LOL! I told him I agreed with his professional opinion!
Sorry you're a 10. Who knows, maybe the Xofigo will turn out to be better for you than the chemo. Give your doc the trials that say Provenge mixes well with Xofigo, as Tall_Allen suggests. Another $100,000 may make the insurance co. eyes glaze over. Hit them in the head with a shovel. And then you can do the chemo. Best of wishes going forward. Crap like this is really aggravating. Apparently insurance doctors have no souls.
The more I learn about insurances the less I appreciate them. We all are just a number and a cash cow. Talking to my MO on Provence. Hes digging into the research and it may be an add-on.
I've always told my wife I'm a 10....and since PCA came along I have documentation to prove it LOL!
All. After reading my replies wherespeel check chamged Provenge to Provence I was reminded that the guy who invented spell check passed away. My he roast in peas....
Bloody hell cobber, that really sucks. Come live in Aussie .... we get that stuff for next to nothing ..eg: Zytiga costs me $5.60 a month. If the Doc says you need it, you get it!
Sorry to rub salt into your wounds and all, but your health system is strange and I struggle to get my head around it. Hope everything works out well for you. "Nil bastados carborundum" Don't let the bastards grind you down!
It seems the rich people have no problems to do what it needs for treatment,i think the insurance company they have their dr.s too to make a judgement.In any case good luck with your treatment.
In sweden we pay tax around 30-32% and if any cancer patient wanted to be treated it cost only 100US dollars but the state of social insurance they have limitation too.
I ran into the same BS. Insurance would pay for cabazitaxel alone or carboplation alone, but not together. Not SOC. The cancer center asked me if I wanted to pay for the carboplatin on my own. Turns out, it was only $40 per treatment!! I said of course I would pay that!.
Next week will be the second infusion of this combo therapy, hope it works.
The insurance companies don't pay list price for drugs..They negotiate with the drug companies for big discounts..The list price for 6 rounds of R-223 is around $70,000. If you can't afford the copay , the manufacturer will cover them...
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Next Treatment Plan Thoughts?
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Post Docetaxel treatment plan
PSMA Scan and HU Altered my Treatment Plan
