Medicare coverage for 177Lu-PSMA617 treatment?

[Shams_Vjean]

With the recent FDA approval of 177Lu-PSMA617, does anyone have a sense on how soon it could be covered by Medicare?

[Tall_Allen]

Usually takes a couple of months.

[Shams_Vjean in reply to Tall_Allen]

Thank You!

[6357axbz]

Nal, I don’t understand why you are talking about FDA approval for “food ingredients”??

[HopingForTheBest1]

If we have a "self pay option" available for this treatment would it be prohibitively expensive for many of us??? How much could it possibly cost out of pocket?

[Shams_Vjean in reply to HopingForTheBest1]

More than ‘a bit steep’ for most of us it would seem:

“Patients will be capped at six doses administered six weeks apart, leading to a potential maximum cost per patient of $255,000, the spokesperson added.“endpts.com/novartis-radioph...

But I imagine the insurance companies will find a way to negotiate a better rate per patient. Too bad some of our federal legislators are refusing to allow Medicare to do the same.

[Hidden in reply to Shams_Vjean]

Holy crap.

[619eh]

I don’t want to be a “Debbie Downer “, but Novartis can’t produce enough Lu-177 to supply the current clinical trials and patients under expanded access. No new patients since November! They are in the process of moving the manufacturing from Europe to New Jersey. Who knows how long that will take. Yet another disappointment.

[Shams_Vjean in reply to 619eh]

I’ve heard about that shortage for trials; but also heard it could be due in part to the fact that with approval Novartis can now get paid for doses otherwise given free of charge to some potential new trial participants, who will skip enrolling into a blind study and go straight to getting the treatment without any doubt of being placed in the placebo arm.

[Shams_Vjean in reply to Shams_Vjean]

I also directly know several individuals who started receiving doses in trial recently at different locations around the US.

[db1966 in reply to 619eh]

Where did you hear this? I have already spoken to my Kaiser MO who hopes to have more details next week about start times which he believes will be a month or 2 latest. One of my work colleagues sister works for Novartisin the Uk and they have been preparing for a while. I’m keeping my fingers crossed as this is my next course of treatment.

[6357axbz]

Thanks Nal

[Foldem]

Aside from shortages, I can’t imagine Medicare not paying for it, now that it’s approved. The whole course, aiui, is about $10k. Xtandi is $9.5k a month.

[Shams_Vjean in reply to Foldem]

Curious where you got that # from? Doesn’t match what I’ve seen published: “Patients will be capped at six doses administered six weeks apart, leading to a potential maximum cost per patient of $255,000, the spokesperson added.”endpts.com/novartis-radioph...

[Foldem in reply to Shams_Vjean]

I just see the amount others have paid to get the procedure is medical tourism on my various support groups. I know the retail price of Xtandi is correct.

[Shams_Vjean in reply to Foldem]

Amazing isn’t it how much less expensive medication costs are overseas than in the US. We have some federal legislators here who seem to think that’s just fine.

[Shams_Vjean]

None of what you’ve described here comes as a surprise to me, Nal. And Novartis moving production from Europe to New Jersey kinda fits into why it’s been used in Europe so long before getting approval here. I imagine there are other Big Pharma players who are not exactly thrilled about this FDA approval. A Sad “State” of affairs in many respects; but I’m trying to focus more on the fact that it’s finally been approved and hoping there won’t be similar ‘roadblocks’ for getting coverage by Medicare now.

[Dett]

I will never forget eating breakfast in the hotel where I was staying while on travel for business and an announcement came on the TV that Fen-Phen and Redux (extremely popular diet drugs) had been implicated in multiple sudden deaths from primary pulmonary hypertension in people who were taking those drugs. I had been on Redux for two months at the time. There had been no prior advisories or warnings at all.

A few years later a fascinating book came out that discussed the machinations behind the approval of these two drugs and revealed the incestuous relationship between the drug companies and the FDA. It was absolutely horrifying. This is the book (Dispensing With The Truth), which I highly recommend to those who can’t believe that the whole process is corrupt:

amazon.com/Dispensing-Truth...

[Shams_Vjean]

Sorry for your losses, Nal. Eisenhower tried to warn us about dangers inherent in the Military Industrial Complex; but much the same danger in terms of lives unnecessarily lost and other excessive costs have been wrought by a different but equally or perhaps even more powerful lobby. One which has steered medicine away from nutrition toward processed chemical solutions. I’m still alive thanks to some of the pharmaceuticals that have been developed, and most grateful for those; but there have also been some significant abuses by the medical industrial complex. And perhaps I’ve been sounding too ‘political’ for the intent of this forum; so I’ll refrain in the future from going any further down that path here.

[j-o-h-n]

Difficult to ring a bell without............. nevermind, skip it.........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/27/2022 8:06 PM DST

[j-o-h-n]

Thank you. Of course and I hope yours was great....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/27/2022 9:51 PM DST

[Hidden]

I was on Xarelto for one month following my atrial-fibrillation ablation surgery. I wasn't keen on taking it but did so for that month. I cheated a bit and took half doses. Even with that I had scary bruising showing up on my feet and elsewhere. I'll refuse to take those industrial strength blood thinners in the future. Sorry to hear about the loss of your neighbors.