Out of pocket cost for Imbruvica: Anyone having... - CLL Support

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Out of pocket cost for Imbruvica

kids4 profile image
16 Replies

Anyone having difficulty with "funding" for Imbruvica. My insurance pays appx 7,000.00 per mo, and I have to come up with appx $3,000 per month. Tried to talk to J&J...we make too much money. Which is just about the cutoff for help. My husband is practically totally disabled..All extra goes toward his care. No one is interested in the situation in my home. i.e., J&J, my insurance co, Soc.Security, L&L Society. I'm exhausted filling out applications, etc, . Anyone having difficulty?

We worked many hours and years all of our lives, paying honest taxes, etc.

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kids4
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Cllcanada profile image
CllcanadaTop Poster CURE Hero

What country?....

~chris

kids4 profile image
kids4

USA

Ezjacobs profile image
Ezjacobs

Check out the CLL Digest for October 21 to October 22, There are references to a number of less costly possibilities including the new AARP/United plan for 2017 with a monthly cost of under 25 dollars monthly.

Lenny123 profile image
Lenny123

A constant fear of many of us on this very expensive medication. currently jnj, forgives copay for private insurance, so you should fall into that camp. Unlike medicare in which copays are due. This has to be requested. from the pharmacy that supplies medication.

virdieblue profile image
virdieblue

My cancer center applied for co-pay aid for me. I didn't get it but am thrilled only to pay $500. Maybe you can ask there. Are you on Medicare?

Virginia

33325 profile image
33325

The clinic I go to went to bat for me

and I pay nothing. I am a widow with a high functioning autisic son who is 41yrs old and lives with me. In the begining of the year they ask for $400 and then it's back to nothing. I guess it depends on your part D ins.

Bless the clinic and the social worker who got it done.

Keep your head up and fight on!

Bonnie

Robby1212 profile image
Robby1212

I am currently into my 4th month on Imbruvica. In addition to being initially reluctant about going on the drug, I was shocked about the extremely high cost. I live in the US, am 67 years old, retired, and receive Medicare and have a Part D prescription plan that covers most of the cost. Those aware of how Medicare’s Part D prescription plan works know that the high cost will take a Medicare participant from the Initial (prescription) Coverage Stage, through the Coverage Gap into the Catastrophic Stage in one fell swoop. Simply said, I pay out of pocket $2942 (Specialty drug, 33% of cost) the first month and thereafter $100 per month since my particular prescription insurance has a $100 cap all through the Catastrophic Stage. This cycle will repeat beginning each January. I, too, did not qualify for any special drug funding because of my income. Although the cost is high, it’s doable for me. Hope you find an answer to your Imbruvica financial problem. Best of luck.

Robby1212

Rt2000 profile image
Rt2000 in reply toRobby1212

I have not come across a Medicare D plan with only $100 catastrophic coverage. Whose plan do you have?

Cindy002 profile image
Cindy002 in reply toRobby1212

How much is the plan D premium?

LarryK profile image
LarryK in reply toRobby1212

What Medicare Part D plan do you have. I need to inquire because AARP/UNH co-pays are astronomically higher. $19,000 a year.

Ngtinfu profile image
Ngtinfu in reply toRobby1212

Robby, can you share which Plan D coverage you have? Thanks.

Robby1212 profile image
Robby1212 in reply toNgtinfu

Hi Ngtinfu. As mentioned in an earlier post, I have a Plan D Rx plan that is offered to retired PA educators through the Health Options Program (HOP). This is provided by the PA Public School Employees Retirement System (PSERS). At the time of that post, about 3 yrs. ago, my cost for Imbruvica was $2900 for January and $100 per month for the remainder of the year. Each year the cycle begins again. I consider myself VERY fortunate to have a plan such as this.

Ngtinfu profile image
Ngtinfu in reply toRobby1212

Thanks for your reply. We should all be so lucky!

Robby1212 profile image
Robby1212

My Rx plan is offered to retired PA educators through the Health Options Program (HOP). This is provided by the PA Public School Employees Retirement System (PSERS).

Rt2000 profile image
Rt2000

Thanks. That explains it. You are lucky to have such a good plan. Wish it was generally available. But it would probably be very expensive.

Gracescooter profile image
Gracescooter

Check out funding thru PAN and johnson and johnson. Our pharmacist /dr office got funding for first 4 months free. They said after that ran out they can apply to drug company as a hardship. They took care of everything. We just needed tax returns

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