Financial assistance with Xtandi - Advanced Prostate...

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Financial assistance with Xtandi

Madbeach profile image
25 Replies

help with cost of Xtandi. Our insurance will not pay anything for the Xtandi. We aren’t rich but make a little more than the income limits fro some of the places that offer assistance with the monthly cost of this $12,000 drug. Any suggestions.? Does the VA benefits cover or help with this cost?

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Madbeach profile image
Madbeach
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25 Replies

The VA should cover most of the cost. Make an appointment with your VA PCP and he/she will guide you through the process including a referral to oncology. If you run into problems schedule a consult with your local DAV rep. You don't have to a DAV member to receive assistance.

Madbeach profile image
Madbeach in reply to

Thank you very much. I will have my husband contact the Va.

Magnus1964 profile image
Magnus1964

VA should provide xtandi at little or no cost.

Duk26 profile image
Duk26 in reply to Magnus1964

Does anyone know if you want to get the drug Xtandi thru the VA do you hv to use their oncologist? My husband has a good one but the drug has just been prescribed and it seems insurance will pay $11k but our copay will be $3k every month! The pharmacy at Emory is checking for financial plans but I am also trying to find any possible reductions for this absurd cost and wondering if he can get drug thru VA but use his own Oncologist Thanks

Magnus1964 profile image
Magnus1964 in reply to Duk26

I don't know. I would certainly call the VA and ask.

Can you reveal the what health insurance you currently have? It helps to know which insurance companies are denying coverage for medications that are universally accepted as SOC.

Madbeach profile image
Madbeach in reply to

We have regular Medicare but not Medicare D, because our supplemental is through Highmark Blue Shield (the also serves as our drug coverage) and that is who denied the coverage....

in reply to Madbeach

I'm not on Medicare but you cannot be alone in this situation. I wonder if anyone else on this site has been in the same situation?They may be able to provide guidance.

Concerned-wife profile image
Concerned-wife in reply to Madbeach

You have appeal rights under Medicare.

I'm a VA patient and they cover my Zytiga, but they also cover Xtandi. The per-month co-pay is very low.

2dee profile image
2dee

Locate your Nurse Navigator for guidance. Your MO should also recommend solutions. Contact the manufacturer directly to pick up what others don't. All were a help to me resulting in 0 out of pocket for the last year. 12k a month is just not doable for many.

I'm in US, 78yr old, United Healthcare, Medicare, and could use VA if absolutely necessary. Manufacturer's help program is vital and so much appreciated.

2Dee

tarzan11 profile image
tarzan11

I have been on xtandi for 5 years. I have medicare and united healthcare supplement thru AARP. However I get the xtandi thru the VA at no cost along with all my meds. My cancer doctor is not in the VA but the VA requires I see their doctors every 6 months to get meds. They have to approve the way im being treated. Recently they have become even more insistent that I follow their doctors protocol in order to get my meds for free. I have politely said no and they haven't issued an ultimation yet. They want me to go on just Lupron to save them money. But that's another story. I receive agent orange benefits as I served in Vietnam. That is why I get meds for free plus monthly check . You can go the nearest American legion office and ask for advice in getting benefits from VA. They did all my legwork. I hope you get the help you need. Without the VA I could never afford xtandi etc

monte1111 profile image
monte1111 in reply to tarzan11

Swing on, Tarzan, swing on.

EdBar profile image
EdBar

Have you contacted the Xtandi patient assistance program? Go to their website, there’s a phone number for the program and you can call them to see if you might qualify.

Ed

larry_dammit profile image
larry_dammit

Get in touch with Xtandi direct, they have a program themselves, I make to much as well but you might luck out, my dad was on zytiga and got it free due to his low income Good luck warrior 🙏🙏🙏🙏

golddiggingrandy profile image
golddiggingrandy

My doc got me in touch with Conexus pharmacy about a year ago and said there was a grant that was free and 0 copay I didn't have to do a thing. I live in Montana and have it delivered to my door every month. I don't ask too many questions " look gift horse in the mouth " but they call me every month to confirm my desire to continue and send the next month free. Thank God

monte1111 profile image
monte1111

As others have noted, is Zytiga an option?

Rich0333 profile image
Rich0333

The application for financial assistance was very simple and approval quick for 100%. The triggering question as I understand it is "are you on Medicare?" Feel free to contact me with any other questions. I was only on it for a couple of months as the side effects were too much for me. Significant memory issues. Trigger for arthritis that I never suffered with previously.

E2-Guy profile image
E2-Guy

OMG...$12,000/month!

Shooter1 profile image
Shooter1 in reply to E2-Guy

Yep, that's right. With my aPca treatments Medicare wanted $6,000 per month co pay. I worked an extra 1 1/2 years to keep med coverage at $32,000 a month before I was able to retire with VA picking up Xtandi costs. Sad but true, this country lets Its elderly die rather than provide treatments if you can't pay for them... 4 1/2 years into this trip, I am doing well and enjoying life... Life is Good.

E2-Guy profile image
E2-Guy in reply to Shooter1

Wow Shooter, I just read your history...you have been through the sh*t! I hope they can zap that tuberosity lesion and get you back on track. I can't believe these insane prices of meds. I think that if my tE2 gel stops working, I will just take a bunch of sleeping pills and call it a day!

Shooter1 profile image
Shooter1 in reply to E2-Guy

My Provenge in August. I had 3 treatments.. $97,500 each. Insurance will only pay once even if effects ware off. Darned cheapskates. Life is Good, so in health insurance.

E2-Guy profile image
E2-Guy in reply to Shooter1

$292,500 for 3 Provenge treatments? I can't even conceive of such nonsense!

Shooter1 profile image
Shooter1 in reply to E2-Guy

When I didn't have transportation for on trip, they sent a Lincoln town car and driver to get me at home and return me after the treatment... 12 hr day for the driver and 450mi. on car.... They said I might be able to get it again in 5 yrs if I want to pay out of pocket. Yeah, right. Just pocket change.

Boywonder56 profile image
Boywonder56

Should be no qiestions asked from va....if they do ask questions...blame it on brandon......ty for your service.......btw my erleada.....16,000.00...month x 4.5 yrs....bingo!

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