Price difference between 250mg and 500mg Abiraterone

[Rodeoz15]

Hi all

My father was prescribed 1000mg daily dose (500mgx2). As the hospital was out of stock of 500mg tablets they gave us an equivalent amount of 250mg ones.

One thing that struck me was that 120 tablets of 250mg Abiraterone cost half that of 60 tablets of 500mg here. This was true for all generic brands.

Is the 500mg dose superior in any way other than the comfort of taking one tablet instead of two? I note that 250mg is uncoated and 500mg is coated. My dad did say that he experienced a lot of gas when he took 250mg (4x). Would switching to 500mg (2x) help?

Thank you!

[spencoid2]

I doubt there is any difference in terms of active ingredients. are you paying for this out of pocket and needing to reduce the cost? here in the US my insurance (medicare and blue crap) is "billed" something like $2000 per injection for Firmagon. Abiraterone "costs" about $12,000 per month for 120 250 mg tablets. When I was in Paris i got a Firmagon shot and the total cost with two office visits EKG bloodwork and prescription was a little over $200 so if they charge similarly for Abiraterone, I would take a vacation or two in France. If for some reason my insurance stopped covering Firmagon or Abiraterone, I could probably figure out some way to getting it in Paris without staying there forever. If my father dies before I do i might just move into his apartment.

[Rodeoz15 in reply to spencoid2]

Thanks. Yes, insurance in India does not cover medicines (at least private insurance does not). Although lot of generic medicines are available. 120 tablets of 250mg cost $150 and 60 tablets of 500mg cost around $270. As I will be paying out of pocket every month might as well buy the cheaper version if there is no other difference.

[cesces in reply to spencoid2]

"Abiraterone "costs" about $12,000 per month for 120 250 mg"

It costs closer to $250 per month through goodrx.com

[dhccpa in reply to cesces]

The generic?

[hg115pb in reply to cesces]

I tried to use that when I first. started therapy and awaiting insurance approval. I went to the Costco pharmacy and they said they were not accepting it for this drug as they were losing too much money. Which pharmacy are you using that accepts this option?

[cesces in reply to hg115pb]

They were all about the same price.

Sounds like the local pharmacy was gaming their numbers by stocking from a more expensive manufacturer.

If they don't honor the coupon, it is often that the coupon is for a different manufacturer than the one being used by the local pharmacy.

The solution is that they order your Rx from the right manufacturer.

Call goodrx when you run into this problem. They actually pick up the phone and will call the pharmacy and sort out the problem.

You just have to give them a few hours sometimes. If it is a few dollars, I don't bother. But if it is real money I have never had them fail me.

If you have a local pharmacist who is gaming their quarterly performance numbers for headquarters, I would stay away from them. They will likely game you in ways you are unable to observe.

I discovered this by accident at a local pharmacy with a pharmacist assistant that was a little too chatty, a little too honest and a little too naive.

I really liked their service and their convenience, but I could just never bring myself to ever go back to them again. Though probably the managing pharmacist has since been promoted out of there to be put on the executive track.

[cesces]

Check to see if one was generic and the more expensive one with the coating non-generic.

That would explain everything.

[Rodeoz15 in reply to cesces]

Both are generic. In fact for all generic versions of Zytiga here 250mg is roughly 50% cheaper.

[cesces]

Wow. On goodrx there was a 10x difference in price!!!!!!

$250 (250mg 120 tablets) vs $2500 (500mg 60 tablets) both pills being generic

I would talk face to face with a dispensing pharmacist and ask them to find out what exactly is the difference between the two pills.

My suspicion is they are two different manufacturers. And the cheaper one may be cutting corners, some obvious (no coating) and some less obvious, contamination, concentration, quality control, rat droppings, etc.

Please report back what you learn.

[Rodeoz15 in reply to cesces]

Will do. Although in my case it’s the same manufacturer in each case selling the 250mg at a much cheaper price.

[cesces in reply to Rodeoz15]

This is all very confusing.

Cost of manufacture for the active ingredient is identical.

The cost of manufacturing pills is a rounding error.

[Concerned-wife]

Great question and research. Thank you. It appears that the 500 just became genetic this year so perhaps the price will drop. It seems that the 250 dropped after it had been generic awhile. We are so grateful it became generic

fdanews.com/articles/200834...

[Rodeoz15 in reply to Concerned-wife]

Thank you. That was helpful.

[rmarkley]

One thing about the lack of coating on the pill is that a lot of the 250 mg abi are being taken with a low fat breakfast, and you want rapid absorption. The coating would slow down absorption. My 250 mg abi says on the container MFG: Jansen Biotech. The pills are uncoated, and have AA250 on one side, and are white oval tablets.

[Rodeoz15]

So I spoke to the Area Sales Manager of Sun Pharma (one of India’s biggest Pharma companies). He confirmed there was no difference between 250mg and 500mg in terms of composition (or quality) and that most generic producers of Abiraterone in India have withdrawn the 500mg pill because it was large in size and there were lot of complaints regarding this - plus the price difference ensured people were mostly only buying the 250mg variant. He didn’t have an answer for why there were such a huge price difference between the two variants.

Another good thing was that he procured the 120pill bottle for me for Rs 10,500 (USD 140).