Pluvicto (lutetium Lu 177

[anonymoose2]

Questions

Just got done with Gallium-68 showed limp nodes, spine, Arms and crown of head

1. Does Medicare approve Pluvicto (lutetium Lu 177?

2. I’ve had Radiation, And 24 months of Lupron and xtandi. And now my PSA is rising. Are you required to do Chemo before they approve?

Thanks 👍

[Tall_Allen]

Yes, after chemo, unless on a clinical trial.

prostatecancer.news/2020/08...

[anonymoose2 in reply to Tall_Allen]

Thank you for the information TA. That’s what my MO mentioned but said I could try but I’m not going to waste time. Get the Chemo and move forward

Anyone know about Medicare picking up the 80%? Did a search and nothing 🤷

[Tall_Allen in reply to anonymoose2]

It is covered by Medicare + Medigap.

[anonymoose2 in reply to Tall_Allen]

Thanks again 👍

[tango65]

Pluvicto is approved by Medicare.

They do not require chemo to pay for the Pluvicto. Medicare pays based in medical necessity.

I had Pluvicto paid by Medicare and I never had chemo since I can't have chemo because a severe peripheral neuropathy. Your oncologist may be able to get around the chemo issue, patient with multiple pathologies etc. etc.

The confusion comes because the FDA approved Pluvicto for patients who have had chemo. For Medicare Pluvicto is an approved treatment and it may be used based in medical necessity.

I had personal interactions with people managing Medicare part B in my area and that is what they did explain to me. They told me that after treatment when they receive the claim, if there was a medical necessity for the treatment they will approve payment and they did.

[anonymoose2 in reply to tango65]

Thank you for the information. I just got a new MO today. This MO is near the medical clinic that administers Pluvicto and as soon as he reads my files they will schedule an appointment and I will be discussing this with him. For I too have neuropathy but I don’t know how they classify the severity. All I know I haven’t felt my right toes in over 3 years. I will let him make the call and hopefully he has more experience with Pluvito and see if what I can do. In your experience what is severe peripheral neuropathy? Whatever the case I must move forward with treatment.

Thanks again Tango

[tango65 in reply to anonymoose2]

For me is the intensity and the extension of the symptoms , the presence or absence of fulgurant pain and the amount of medicine to control the symptoms.

Medically , there are classifications:

advancedreconstruction.com/...

I wish you the best of luck with the treatments.!!

[anonymoose2 in reply to tango65]

Great link 👍

Thank you!

[tango65 in reply to anonymoose2]

If you have a peripheral neuropathy chemo is not indicated if there are other treatments. Just consult with a neurologist. all the neuro I saw advised me against having chemo.

[lokibear0803]

My understanding from conversation with my MO is that you need only to be exposed to chemo, you need not do the full course. If needed when the time comes, my plan is to get one infusion, then refuse to continue and move directly to Pluvicto. My hope is that, by that time, one can get Pluvicto w/o taxanes at all.

[tango65 in reply to lokibear0803]

It is based in medical necessity. If you have one dose of chemo and you have complications documented in your chart, then you could proceed to Lu 177 PSMA 617.

[CRPCMan]

There's an answer for you and its not LU177 but I can't say it on here unfortunately and it truly saddens me.

[CAMPSOUPS in reply to CRPCMan]

Lu177 has extended life for many a soul. If you cant discuss the outlawed concoction you took or take why bother responding. No offense but you often reply with the same "I cant talk about it" sentence.

[anonymoose2 in reply to CRPCMan]

After reading your Bio I see what you can’t say is PCSPES. I did a google search and it popped right up.

You are welcome to contact me by DM.

Many alternative medical treatments out in the world.

What is incredibly interesting is Chinese medicine. I got to personally experience Chinese medicine in Reno Nevada at a clinic that did only Chinese medicine. After my wife was diagnosed with a disease that was deemed incurable she went there. Well all I got to say is it cured her. Never to return.

I remember it as it was extremely expensive and no insurance would cover it.

So I’ll leave it there.