Abiraterone costs via insurance

[Wildfun44]

Team, thought I would check to see what everyone's financial experience has been who are using generic Abiraterone Acetate. My BlueCross BlueShield uses CVS exclusively for handling all my meds. CVS is charging me/my insurance $9,650/m for generic Abiraterone. I can find it at Costco and Cost Plus for less than $200/m but CVS says I would have to pay 100% out of pocket if I didn't buy through them. With me maxing out my deductibles and copays early in the year, it's cheaper for me personally to buy AA through my insurance/CVS than to spend another $2,400/year out of pocket for Cost Plus AA. But it drives me crazy to see this kind of waste and CVS getting almost $120,000 for a $2,000 generic.

Thoughts from the group? Workarounds?

[Hidden]

"CVS is charging me/my insurance $9,650/m for generic Abiraterone."

Believe me, your insurance is not paying that

CVS might be billing that much, your insurance will pay them a whole lot less!!!!

More like $148.00

[Cactus297 in reply to Hidden]

The Mark Cuban online drug website has generic Zytiga 90 day supply for about $100. Try Googling

costplusdrugs.com/

Hope this helps.

[Hidden in reply to Cactus297]

That might be, but your Dr will not prescribe more than 30 days. You need blood tests every month to get a new 30 day supply. They might offer 90 days, but you won't get a script for 90.

[Alturia in reply to Hidden]

My oncologist had no problem writing a 90 day prescription for abiraterone right from the start. I was getting blood tests every 2 weeks for the first 3 months.

[jmarsh in reply to Hidden]

Not so for me. I get 90 days and blood test every 90 days

[Cactus297 in reply to Hidden]

There’s a 30 day option on the site too if that helps.

[Wildfun44 in reply to Cactus297]

thanks Cactus297. I can buy the cheaper generics but that will come 100% out of my pocket. So I have to buy the $120,000 version so my insurance will cover. I talked to a medical insurance COO playing golf recently. Told him this story and he said CVS probably signed a contract that they would get a 40% kickback if they only sold the $120,000/yr ABI so it is much more profitable for them vs giving me a $2000/yr option.

[Hidden in reply to Wildfun44]

Dilema to CVS parent company: Aetna!!!

[Hidden in reply to Cactus297]

90 "count"

4 pills a day

Thats 22.5 days

You would need 120 "count" for the month

[Cactus297 in reply to Hidden]

You are right it’s 4 doses daily so that changes the pricing…perhaps an error on their part. You could have your doctor contact them, but the pricing would be a bit more. One group member in another group was paying over $400./mo so Cuban was very helpful to them, but it’s not for everybody. It depends upon what you’re paying and sometimes other factors. Thanks for pointing that out!

[Hidden]

Zytiga is not prescribed for 90 Days, only 30.

30 Day script after monthly blood tests

[Cactus297 in reply to Hidden]

You can also order it for just 30 days. It’s $33.60 for 30 days.

[Gearhead]

Wildfun: See recent similar post and discussion on this topic:

healthunlocked.com/advanced...

[Huzzah1]

My Medicare drug plan is with AARP Medicare Rx - United Healthcare. I think my deductible is about $300. My monthly Abi is $95.

[j-o-h-n]

No wonder they loot from pharmacies.........

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 05/16/2023 10:50 PM DST

[Derf4223 in reply to j-o-h-n]

You set a great example of keeping it light and being serious when appropriate. And you've battled the Beast a heck of a long time. Do you like the singer Prince? Check this out. Now that I am 1 year from diagnosis of Stage 4 Advanced Very High Risk PCa, responding well after ADT/RT/ADT/Abi, and not holding my breath as much, it hits some notes that really resonate. youtube.com/watch?v=aXJhDlt...(Not working as expected?)

[j-o-h-n in reply to Derf4223]

Thank you. After the tiny little bastards bit me It took me awhile to come to the conclusion that I would lose the battle but I'll be laughing all the way to the comedy store in the sky. I was diagnosed at age 66 and my son was 12 years old, a difference of 54 years. That made me depressed thinking about leaving my son but I realized, hey fuck that and I did a 180 turn into laughter and it's true that laugher is the best medicine. I'm 86 now and my son is 32. (enjoy life and laugh)

Prince is not my favorite.

Bruno Mars is.

youtube.com/watch?v=OPf0YbX...(Not working as expected?)

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 05/17/2023 1:23 PM DST

[Cactus297 in reply to j-o-h-n]

Your story and attitude are wonderful. My son has a similar positive attitude so hopefully he will make it to his 80’s too. He was diagnosed at 49 last year just before his 50th birthday. Attitude really does count plus of course good meds and doctors. He hasn’t changed his lifestyle one bit and to date blows off most side effects…was actually just promoted. As his mother I am the one that fights caving in. Thanks for all your upbeat funny posts!

[Cactus297 in reply to Derf4223]

Your situation is a lot like my 50 year old son. Diagnosed with pc and then 2 months after surgery psa of 20! IMRT to th pelvic lymph nodes, generic Zytiga/prednisone, and Lupron. 3 mo f/u was .07 . Augu 7 next PSA.Fingers crossed.🤞

[Todd1963]

most manufacturers of Zyt/Abi have a copay assistance program. I pay $0 a month

[Wildfun44 in reply to Todd1963]

Thanks Todd. Been out of pocket but appreciate the feedback on copay. CVS has their own Abi so they don't let me get any of the Zytiga or others who might copay.