Cost of Xtandi

[PastaMan20]

I am about to go onto Medicare. The cost of all drugs seem exorbitant. How do I get financial assistance without going broke?

[Hidden]

Unfortunately Xtandi does not give financial support to Medicare patients, whether on true Medicare. Medicare Part C plans with Part D, to Part D only plans.

[PastaMan20 in reply to Hidden]

thanks

[Echotango51]

I’m on a Medicare Advantage Plan, I have a friend on Medicare with a supplement. We both get xtandi for free. Ask you doctor to reach out to Astellas Pharma /Sonexus Health Pharmacy Service, it’s based on your income.

[Hidden in reply to Echotango51]

Do you lie about being on Medicare?

I contacted, and was showed this:

The Program is not valid for patients whose prescription claims are reimbursed, in whole or in part, by any state or federal government program, including, but not limited to, Medicaid, Medicare, Medigap, Department of Defense (DoD), Veterans Affairs (VA), TRICARE, Puerto Rico Government Insurance, or any state patient or pharmaceutical assistance program. 

[Linebacker75 in reply to Hidden]

I’m on Medicare with a supplement and have tried using the $25 copay cards, free prescription cards etc given to me by my doctors and was shot down every time. Medicare will not allow any discount or lower cost coupons. I’ve never tried getting meds free from the manufacturer based on anything other than outrageous prices but if reading Medicare rules correctly it’s a no go. They’re are always happy for me to pay cash and not file for insurance on the meds at all. Go figure.

[leebeth in reply to Linebacker75]

Copay cards are not allowed to be used with any government programs, per legislation. However, patient assistance programs are allowed, and most manufacturers have generous programs.

[Echotango51 in reply to Hidden]

NO I didn’t lie about being on Medicare, I’m on a Medicare Advantage Plan, Humana Choice PPO. Advantage plans aren’t true Medicare, however, they follow the same guidelines that Medicare has. My friend is on Medicare with a supplement, plan G I think. We both are getting xtandi at no cost.

Several years ago when my PSA started to go up slowly. I told my URO if I had to get xtandi from my Advantage Plan it would cost 3k a month. He told me not to worry about it, they us a specially pharmacy. That’s how my friend and myself get xtandi free.

I was trying to help one of our brothers out with the info I posted.

ET

[Seebs9]

I have an almost full bottle available after I start pluvicto this Friday. PM your address and I will send it to you

[larry_dammit]

just rea$ the post about Xtandi not giving assistance, new one on me. I haven’t checked in the last 2 years as I don’t qualify but they did have a program to furnish the drug free if you fall in the guide lines. Just contact them directly and they will give you the guidelines. Costly battle there warrior, I’ve been on Xtandi now for 6 years. Thank goodness for the supplement insurance.

[Skifanatic]

I receive Nubeqa for free, from Bayer’s foundation, based on my income (not assets) being less than 500% of the federal poverty level, which is just over $90,000. I also found a supplemental plan (provided one has a Part D Medicare plan in place) sponsored by the state of Massachusetts (Prescription Advantage) that picks up 100% of the cost after $4083 out-of-pocket. Maybe your state has something like this? Call the company, or have your doctor call. Be persistent. There seem to be some good options available if your income is under $90,000.

[rick8637 in reply to Skifanatic]

I believe orgovix support uses a factor of 400percent times the poverty rate or approx 72k as their criteria to supply the drug for free. At least that what it was last year!

[Teacherdude72 in reply to Skifanatic]

This I didn't know, I too am on Nubeqa and would love to know how to get into this program.

[Skifanatic in reply to Teacherdude72]

Here's a link to the Nubeqa program: patientassistance.bayer.us/...

[Concerned-wife]

medicare.gov/basics/costs/h...

[MustangGuy]

Make sure you do STANDARD MEDICARE with a Supplement Part G and good part D..you can shop those plans to see who offers the best prices. ALSO the Mark Cuban Cost Plus Drug company is now offering Abiraterone (Zytiga) for only 125 per month compares to the $585 price I had with my Part D provider. Whatever you do DO NOT take an Advantage Plan C especially since you already have cancer . You will never be able to change back and the long term costs will be MUCH higher and they insurance company can deny all kinds of life saving treatments. I am a patient at Mayo and they notified all their patients that they will no longer accept ANY Advantage Plans. When we asked them why they said because the insurance companies were denying so many of their treatments and were very slow to pay. Another large provider I use also have stopped accepting them. Don't buy into the marketing BS the Advantage Plans use to convince you they are cheaper..It's a lie.

[hfl20 in reply to MustangGuy]

I agree 100%. The advantage plan private insurers are paid a hefty bonus up front when signing a subscriber and as MustangGuy states - you are stuck with a privately managed plan and "underwriters" being involved in your care decisions for the rest of your life. My wife and I signed up with traditional medicare with separate supplements a few years ago mainly to have access to any healthcare provider we choose (that accepts medicare) in the US during travel. Fortunately, due to that decision 4 years earlier, when I was diagnosed with prostate cancer last year, I was able to select where I would be treated. I chose MD Anderson and other than travel expenses, Medicare, Mutual of Omaha (plan G), and Wellcare (plan D) have paid for everything except minor deductibles. For the hefty drug copays, MD Anderson helped me apply for grants which I received to cover most of the copay. The grants are totally based on income, not assets and as stated above qualification is based on multiples of the federal poverty level.

[Fightinghard]

contact these organizations for assistence. They have income limits (close to $90k)

Patient Assistance Network. PAN

The Assistence Fund. TAF

[EdBar]

Xtandi has a patient assistance program that is pretty easy to qualify for, I’m on Medicare with a part D and I don’t pay anything for Xtandi.

[dhccpa in reply to EdBar]

Strict income limits?

[EdBar in reply to dhccpa]

No, not really, pretty easy to qualify.

[FRTHBST]

I agree with MustangGuy's advice. A friend who advises on setting up Medicare for a living gave me the same info; real Medicare with a supplemental G and part D is what I have. Advantage is a private plan and they can deny and delay coverage-like most private insurance there are networks and other limitations. Advantage was G W Bush shot across the bow toward eliminating Medicare completely and replacing with private insurance. You have a limited time window of a period of months to make this choice.

Just visited with a high school friend who was partially paralyzed in a fall when a kid. He suddenly realized that Advantage was a mistake and when he wanted to change the to real Medicare 2 years in, the premium would be close to $1000/month. Also, if you are lower income, most states have an "extra help" provision which will pay the $165/month cost of the regular Medicare premium as well as the part D premium, you will have to search this out, so talk to your state health department as there may be a time factor here too.

As for the cost of some of the meds, my MO says that none of his patients are paying those high costs.

[Magnus1964]

Depends on what state you live in. Sometimes using a discount card without your Medicare card works better.

Also try the Patient Advocate Network.

If all else fails, get xtandi from India.

Magnus

[RCOG2000]

i purchase mine in generic form from pharmacy in India. Generic is approx 275$ per month for one month supply at 160 mg per day dosing

[dhccpa in reply to RCOG2000]

Any problems with the process?

[RCOG2000]

i have had three shipments. One was delayed several weeks in customs in NYC and FDA inspection Other two were on hand in less than a month. Most recent cost was 285 for one month

[LaxMan75 in reply to RCOG2000]

Which vendor in India did you use?

[RCOG2000 in reply to LaxMan75]

letsmeds

[LaxMan75 in reply to RCOG2000]

Thank you!

[Muffin2019]

If you are using a hospital pharmacy you night be eligible for financial assistance based on income only. Talk to the pharmacy and research the subject, there is help out there.

[PapaDugi]

I was paying about a $600 copay for Xtandi with Medicare part D. I had withdrawn money from an IRA acct so that counted as income. I did not withdraw any money last year and I now qualify for no cost Xtandi and orgovyx. They both look at income only. They don’t look at ant assets you may have. Apply to the manufacturer.

[FortyWinks]

I’m Wales and was diagnosed during lockdown. Fortunately we don’t pay for prescriptions in Wales and because of lockdown and the risk from chemo, was offered Xtandi upfront. The cost to the NHS is nearly £3000.00 per 28 days. Count myself as so fortunate as two and a half years on, well glad I’m still here but I’d be broke. Sadly, HMO are moving in on the NHS and our current right wing regime is ideologically opposed to free at the point of use healthcare and want an insurance based system so I might struggling with the challenges described. Sadly, so many don’t see the writing on the wall. I feel for you.

[Tristag]

Hopefully we can take the $ hits until Bidens pharmaceutical caps take effect.

[Shams_Vjean]

Yes, Biden’s 2022 Inflation Reduction Act is set to cap out of pocket costs/spending for Medicare Part D plan participants at $2,000 per year, starting in 2025; unless it gets ‘derailed’ before then by, you know, those politicians who hate “socialism”, and also by association, we cancer patients whose burdens are lessened by programs like Medicare.

[Kevinski65]

if you make less than 80000 you can qualify. Google Astrellas and read about their’ program.