Orgovox your experience with this - Advanced Prostate...

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Orgovox your experience with this

Gerald2022 profile image
19 Replies

I am currently on Eligard my doc has suggested trying Orgovox would like to know what others have experienced using this medication. With Eligard I have a problem with significant hot flashes.

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Gerald2022 profile image
Gerald2022
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19 Replies
Alturia profile image
Alturia

I believe that the hot flashes are caused by the low testosterone rather than by the Eligard. So I suspect your hot flashes will continue no matter what drug you are taking to lower your testosterone.

Stevana profile image
Stevana

Hello G,

I have been on Orgovyx for around 19 months. I decided it was more convenient than monthly Firmagon shots in the belly. I haven’t experienced any difference in side effects, re same fatigue, hot flashes and a life devoid of sex. Otherwise, I’m doing pretty well. One advantage of Orgovyx over Firmagon and Lupron is the lower cardiovascular disease profile claimed by Orgovyx. Other than that advantage I’ve experienced no difference in the side effects in the two therapies I’ve used.

It can be somewhat tricky to navigate the insurance coverage. I have BCBS FEP for my drug plan and pay a monthly $10 copay for Orgovyx. Your doctor and treatment center should help you get approval through your health insurance provider. Should you experience greater adverse side effects on Orgovyx (and I’d be surprised if you do) you can always switch back to Lupron. It’s more or less a matter of convenience and the discomfort of the regular injections that convinced me to go with Orgovyx. Hope this helps. Good luck.

maley2711 profile image
maley2711 in reply to Stevana

You have private insurance and not Medicare drug coverage? Surprised that pill was covered ..... some convincing evidence for the need for a pill was presented to the insurer? Many men have said not covered and paying $300/mo or more.

RugbyVLS profile image
RugbyVLS in reply to Stevana

Interesting to hear about your copay. We also have BCBS FEP (primany), but were told our copay is $85/month. Do you think it matters what state you are in? We also have Medicare and Tricare for Life. I'm happy to have a relatively low copay compared to many, but sure would like it to be better with all the insurance we have.

Stevana profile image
Stevana in reply to RugbyVLS

See reply to Maley2711 above. Also, you should inquire at BCBS FEP about their Medicare Reimbursement program. When Medicare is your primary and picks up the majority of all outpatient doctors care, BCBS will reimburse you for a portion of your annual Medicare premium payments. You can receive up to $800 per year, per insured on the policy. My wife, who is also on Medicare, and I are both receiving this reimbursement. There’s a link to the program on BCBS's website. You have to establish a reimbursement account and provide proof of Medicare premium payments to get your reimbursement. They also have a staff that can help you thru the process.

Boonster profile image
Boonster in reply to Stevana

Stevana, can you provide the link for the Medicare Reimbursement Program? I couldnt find it on the fepblue.org site. Thanks so much for your help. I believe my wife and I qualify.

Boonster profile image
Boonster in reply to Stevana

Stevana, I just phoned the BCBS FEP call center. BCBS reimburses a portion of your Medicare premium payments only if you have the BCBS Basic Option, not the Standard Option. I have the Standard Option. But thanks for flagging this reimbursement program.

Stevana profile image
Stevana in reply to Boonster

I have basic so was not aware that the reimbursement is not available under standard coverage. Thanks for the info.

Stevana profile image
Stevana in reply to Stevana

I’m 70 and Medicare is my primary provider accept for prescription drugs since I elected to not take Medicare Part D coverage. Therefore BCBS FEP covers all my prescriptions as well as any medical copays required by Medicare. I get my PCa treatments at Moffitt Cancer Center in Tampa Fl. They coordinated with Orgovyx to get me set up for the monthly script with $10 copay. I think this was achieved by qualifying thru Orgovyx.com first. This link: orgovyxhcp.com/_assets/pdfs... , explains the process. It took a while but I eventually got approved by BCBS to receive the monthly $10 script. I suspect Myovant, the maker of Orgovyx, is supplementing the total cost. As I said, Moffitt handled it for me so I’m not certain how I got approved. However, I can say it was not based on financial need. The phone number for Orgovyx is on the form. They have a very helpful staff who can answer your questions and help you thru the process if you want to pursue it. Good luck.

Tall_Allen profile image
Tall_Allen

Most of the side effects are caused by castration-levels of testosterone, so it doesn't matter which kind of drug is used to get there.

Murph256 profile image
Murph256

I’ve been on Orgovyx for 10 months. Previously, I had been on Lupron for 10 months. It might imagination, or I might be getting used to the side effects of castration level testosterone, but it seems as if all the side effects are reduced slightly with Orgovyx. Hot flashes, fatigue, sexual dysfunction, cognitive decline and even body hair loss seem slightly better with Orgovyx. And apparently, t-levels fall and recover more quickly going on and off Orgovyx. All else being equal, I woul recommend Orgovyx over Lupron, of your insurance will cover it

dhccpa profile image
dhccpa

if you're on Medicare Orgovyx will cost a LOT more unless you get help in some way.

Boonster profile image
Boonster

I've been on Orgovyx for about 13 months. It has worked quite well -- so far. The hot flushes are manageable, as is the fatigue. In fact, I had more fatigue from a Moderna vaccination than I have from Orgovyx. PSA level has become undetectable. Even sexual intercourse has been manageable, although I suspect that is more the skill of my wife than anything else. My libedo has certainly taken a huge hit. My co-pay is $10 a month, thanks to Medicare and secondary insurance. Good luck!

Gerald2022 profile image
Gerald2022 in reply to Boonster

Thank you for your responses, I will stay with Eligard for now. I was quoted $960.00 per month for Orgovox I have Medicare and AARP United Healthcare. They said the reason for the the high cost was my income is high.

Explorer08 profile image
Explorer08 in reply to Gerald2022

I have United Healthcare Medicare Advantage PPO with UHC's OptumRx drug program. I was on Orgovyx for 55 weeks (now on an ADT vacation) and the monthly copay was $72.30. Side effects minimal at most. Did LOTS of exercise which helps with side effects.

Stevana profile image
Stevana in reply to Gerald2022

G, I would encourage you to contact Orgovyx 800 number. As I stated in my last response, there was no means-testing in my qualifying for Orgovyx low copay. Your high monthly copay quote my have to do with your particular insurance coverage, but I’m certain Myovant is supplementing the cost and you could still qualify for the lower copay. You may want to explore this further with Orgovyx, without making any changes to your current treatment, and if it doesn’t pan out all you’ve lost is time spent. In my experience I think Orgovyx is the more tolerable ADT treatment.

MateoBeach profile image
MateoBeach

It could be worth a try. I am currently on Orgovyx ADT as part of my mBAT and surprised I am not having hot flushes on it. Mine were terrible when I was on Eligard. Don’t know why but is much better for me.

hfl20 profile image
hfl20

I recently started my 3rd month of Orgovyx (out of 24 months in addition to my proton therapy). I have significant hot flashes, but have learned to just deal with it since they only last about 3 minutes or so. It gives me a chance to practice mindfulness...

As for the cost... I have traditional Medicare, a medigap G plan from Omaha, and plan D coverage with WellCare. I chose Orgovyx for the obvious reasons expecting to pay about $3000 / year. With traditional medicare, your annual drug costs up to $4430 are 75% paid by your plan and 25% by the patient. Between $4430 and $7050 (the famous gap), plan pays 5%, patient pays 25%, and manufacturer pays 70%. Over $7050, medicare pays 80%, plan pays 15%, and patient pays 5%.

Orgovyx bills at $7667.28/ month. Cash price is $4274.14. With my standard medicare, medigap (that doesn't pay for most pharmacy) and my $13/month Wellcare, I calculated my 1st month to be $1010.94, next 3 months at $638.94, and the next 8 months at around $140/month.

MD Anderson suggested I contact the Healthwell Foundation before asking Myovant Sciences / Pfizer to give me a break on the cost. I contacted them, applied online (just for help on the copay specifically on Orgovxy) and received a grant that will pay all of my copay on Orgovyx for a year, when I will need to reapply. Their income guidelines allow applications with an income up to 550% of federal poverty guidelines (about $100k for family of 2).

As for its efficacy, my psa was 19 when I started Orgovyx, 8.9 a month later, and 1.6 yesterday (at about 9 weeks).

leebeth profile image
leebeth

my husband has been on Orgovyx for a little over a year. Prior to that he had 4 monthly injections of degarelix.

He changed for the convenience factor, to avoid monthly office visits. We preferred a GnRH antagonist to an agonist.

He has had no side effects other than loss of libido, body hair, etc. No hot flashes or fatigue. He didn’t have those side effects on degarelix either.

We are fortunate that he has $0 copay with insurance from my former employer.

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