My husband's cost for Nubeqa is very high. It's 2023 and time to meet the new deductible of $3000.
The Bayer website says "The average total cost of NUBEQA for men with Medicare coverage is $1082, with most men paying less than $50 in co-pay" but his co-pay is greater than $600 a month and he has traditional Medicare and a Part D plan with AARP Walgreens.
Wondering what others pay.
Thanks in advance.
I'm wondering the same. Is your husband castrate resistant? It's my understanding that Nubeqa is not yet approved by Medicare for castrate resistant. That may have changed recently.
I don't know if he is officially castrate resistant but his PSA was rising again on Firmagon so Dr. Sartor put him on Nubeqa a year ago and his PSA is 0.03 now.
It is approved for castrate resistant.
May be time for a new plan, my RX deductible is $250 a year.
Even for Tier 5 specialty drugs? I looked at all his options at renewal and there was nothing better available.
Yes as far as I know, i have an advantage plan through AARP and United Health. Most of my generics are free. My Abiratirone is $95 after deductible
I just used the Medicare.gov tool to look at Medicare Advantage plans and all 4 of the AARP United Health Care plans show signifocant costs for Nubeqa. The costs range from about $9000 a year to over $10000 a year.Abiraterone is a generic drug that is usually tier 3 or 4. Nubeqa is a tier 5 drug and I don't believe there is a generic. Tier 5 drugs usually cost a lot more than tier 4.
On my plan $600 a month pretty high. wonder about Mexico, they have generics not available here
I spend half of each year in Los Cabos Mexico. Many branded drugs are much cheaper there and available without a prescription. But advanced cancer drugs are not available at all, at any price that I could find. Not even generic abiraterone much less Nubeqa, Orgovyx etc. Testosterone for BAT is available at every corner pharmacy. Weird.
Nubeqa has no generic. Made in Finland.
This source talks about the legislation to cap patient payments at $2000, down from the current annual $7000. We see these humongous numbers for cancer drugs, but even existing Part D greatly minimizes patient costs.....granted that even the current $7000 is a lot of money, and for a couple $14000......when perhaps retirement income is $50,000, or for many, even less.....that change to $2000 max would be a big deal....
healthaffairs.org/content/f...
The costs I quoted are for 2023. The caps in the new law don't take full effect until 2025.
healthaffairs.org/content/f...
the article mentions current cap of $7000 ????
The new law does change what happens when you reach the catastrophic phase which is $7050 in 2023. Under the new law you will no longer have to continue to pay 5% of the cost once you hit the $7050 threshold. But that change doesn't take effect until 2024.See below for a good explanation of the timing of the changes in the new law.
That is when you reach Catastrophic level.
out of pocket???
If so, this info doesn't agree....
Type in "Medicare Advantage warning". And watch the many videos. Mayo like other cancer hospitals are warning their patients they can't come to MAYO with these plans.
No generic for Nubeqa but you should hit Catastrophic level the first month. See my other post for more
The issue isn't just the annual deductible. Nubeqa is usually a tier 5 drug and most insurance companies require you to pay co-insurance that often is 25% or more of the cost of the drug.
Yep. This. His is an AARP United Healthcare Walgreens plan and it was the best price i could get. He pays about 10k a year. It's painful.
Yes, I looked up the cost of a Nubeqa on the Medicare website for Part D plans and for Medicare Advantage plans. The good news is that the 4 AARP/United Health Care plans are the lowest cost for Nubeqa. The bad news, as you know, is that it is still very expensive. When I saw your post I was hoping that someone would reply that is actually paying less for the drug. Maybe that will still happen.
Thanks for your help 
$10,000 here too when I looked it up for where we live. The recent law should help eventually
are you sure??
Catastrophic level is 5%, still high cost but not 25%.
Try going to their patient assistant program
patientassistance.bayer.us/en/
I get mine for free from my hospital as they are one of the leading hospitals in the country.
See if your hospital can do this as a hardship or a grant
Maybe Sartor would be okay with a trial of enzalutamide before Nubeqa. Side effects can be much worse for some. But others seem to tolerate it okay. Available mail order from India where they have generic versions, but not for darolutamide yet. Has he been on abiraterone previously? Much better tolerated for some and inexpensive generic, especially at 250 + fatty breakfast dose.
The company offer low income assistance. Most people qualify.
I have been on Nubeqa for 21 months now. Three things to know about my payments. First however is I am in NY state. NY has a prescription drug help plan, EPIC, that after I meet my income level requirement it kicks in reduces my cost to $10/month. Second given Nubeqa cost I bust thru the Castastrophic the first month so after Medicare its 25%. Finally I have been part of a help program that helps pay for Prostate Cancer drugs and they have covered the first month. Do a search and you will find several and check your state, if in America, to see if they have help too. PM me if you like.
I just looked at my AARP Medicare Advantage plan part D coverage for Nubeqa. I hit Catastrophic Coverage immediately and monthly cost is $701.45. Read above about my state's drug help program that reduces my cost to $10.00 a month.
Check with your state to see if they have the same. Please PM me for more.
All these pharmaceutical companies have a compassionate use program. I got Nubeqa for free. All it takes is for you to have his treating physician call and ask for it.
I don't understand why doctors don't offer this info.
good luck
My cost is very similar to yours. $3,000+ initial copay. Into catastrophic coverage month one. $704 a month thereafter. This is bleeding me dry and all my congressman can say is..."We're working on it." (meaning getting caps put on cancer drugs).
Urologist Wants to switch from Firmagon & Nubeqa to Lupron with Nubeqa
Xtandi vs. Abiraterone vs. Nubeqa
Any experience with Nubeqa or Darolutamide?
Will Medicare pay for orchiectomy?
