Pluvicto and a port

[Yadifan]

My husband is having his first pluvicto tomorrow and this question didn't occur to me to ask. Has anyone here had pluvicto administered to them via a port? Or is it always through an IV?

[tango65]

The port is connected to a large vein.

[CJ4J]

Pluvicto can't go in the port according to my husband's person administering the treatment. To sticky.

[Yadifan in reply to CJ4J]

Thank you!

[countrymusic101]

Through an IV. I had my first Pluvitco 3 weeks ago and just administered through an IV in my arm.

[db1966 in reply to countrymusic101]

how is your treatment going so far?

[TJGuy]

Curious if private insurance say BCBS is paying for Pluvicto.

I'm curious as to the "list price" for each infusion and then what the Insurance company is actually charged and pays.

Wondering if this is still only Medicare at this time in the US.

[Yadifan in reply to TJGuy]

Not sure what the list price is. We have bcbs and it's been approved. We did have an issue with them covering the psma pet scan. Our doctor had a peer to peer review with the insurance company where they eventually approved it.

[TJGuy in reply to Yadifan]

That's good to hear about BCBS and Pluvicto. My Dr at MAYO and his staff do not perform peer to peer with insurance companies, haven't for probably five years.

So that creates a problem and a whole lot of stress to go ahead with the scan and then have MAYO appeal it afterwards hoping you don't get stuck with $16 K or $20+ K bill.

I heard or read just recently that pre approvals are the greatest reason for doctors quitting. Congress is supposed to present a bill very soon to prevent or cut back on these insurance companies pre approvals. Will have to see if it can then get approved in both houses?

Any chance when you get your EOB from BCBS showing the full price, what discount was given to BCBS resulting in what they actually paid. You might let the rest of us know what the mystery prices are for these for private insurance like BCBS?

For both the PSMA scan and Pluvicto (either single treatment or total treatment costs.)?

Thanks

[Yadifan in reply to TJGuy]

I will be sure to do that. For both the scan and the Pluvicto. I'm curious myself. Haven't seen them yet. But I've been blown away by the EOB on other tests, scans and chemo.

I am so grateful for our MO. He has really fought hard to get us this far. Even to the point of contacting other doctors at other facilities to see if we could get Pluvicto through them. It's ridiculous that he had to battle insurance for us. He has so many other life saving things to do.

[Foldem]

Do not get a port. Before long the friction from movement will start to hurt a lot.

[Yadifan in reply to Foldem]

We've been pretty fortunate with the port so far. He's had it for almost 2 years. Has gone through a lot of chemo with it and lab draws. They weren't able to administer Pluvicto through it. I'm pretty sure he'll have to have it flushed if we're not using it for a while. The nurse struggled a bit with getting his IV going this morning. So I was grateful for the port for all of those past infusions. But like I said...we have been lucky so far.

[countrymusic101]

Finished three rounds of Pluvicto, PSA is coming down every month. Hoping it continues to drop.

[EdBacon in reply to countrymusic101]

What have your PSAs been if you don't mind me asking? I'm getting my first Pluvicto in January.

[ajok]

I certainly hope Pluvicto can be given via my port. I’m supposed to start in early Feb and am lacking all kinds of information. After PET and bone scans on the 31st and 1st, I have a telemedicine appointment set up with a nuclear medicine doctor, so I will ask this and oh-so-many other questions.

My biggest will be: After Medicare and private health insurance, how much is this going to cost me? My wife is a teacher; I’m on Social Security. Not wealthy by any means.

I have told my wife that if it ends up being super expensive, I’ll simply refuse further treatment with Pluvicto. I refuse to die leaving my wife with a mountain of debt. Saying adios a little sooner does not frighten me as much as bill collectors. The hospital is really helping, exploring additional funding. So I’ll just go ahead with the first treatment and see how it goes.

As to the port - I see absolutely no reason why both your husband and I can’t use our ports. But if that’s not possible for some reason, we still have veins.

I wish you and your husband the best of success with this grand adventure - as I do for myself.

[Yadifan in reply to ajok]

It was explained to us that the Pluvicto was too thick to be administered through the port. There is a lot of information on this site regarding Pluvicto. My husband has had 4 so far and has tolerated it well. Finding a vein was not an issue. You will want to hydrate before your treatment. As far as the cost is concerned, I have worries as well. We're still waiting on the EOB from our insurance. We asked our MO before the first treatment if it was covered by insurance and were told that it was. Adding that they don't do anything without insurance approval. Our insurance did not approve the required PSMA pet scan at first but our MO did a peer to peer review with them explaining the medical necessity. We understand that there may be coding issues with insurance and Pluvicto being a new procedure. But the first Pluvicto was almost 5 months ago. After our last appointment a nurse navigator was supposed to get answers for us but still haven't heard anything. Our next appointment with our MO is in 2 weeks with Pluvicto scheduled for that following week. I'm hoping for answers and may have to get squeaky if there are none. I'm planning on posting on this site after our next appointment with questions if I don't get answers and our cautionary tale if I do.

Best of luck to you. I'm also hoping you'll get an idea of cost before you start. The added anxiety of not knowing on top of all the other anxiety is a lot.

[Yadifan in reply to ajok]

There was a post 3 months ago by NotAlwaysSunshine titled "Pluvicto-cost per treatment $162,067.80" . I have this post saved and check on it occasionally to see if there's any new information. There is a reply there regarding Medicare and supplemental insurance. I hope this helps.

[leebeth in reply to ajok]

My husband received his Pluvicto at Mayo, and they would not use his port. Same for my brother at Froedtert in Wisconsin.

However, reading online, it looks like some facilities, including MSK, will use the port.