Financial help for Imbruvica

[12Caine12]

I'm in California, on Medicare with EnvisionRX Plus and have been told I'll need to start Imbruvica at a cost of nealy $10k a year out of pocket, not to mention the possiblility of other Rx's due to complications. Is there any financial aid out there I can research? Thanks in advance.

[Kokobean]

The medical facility you go to should help you with getting that help. There is a program called YOU&I. I haven’t had much luck when I contacted them, but was told at the Mayo that is a reactive program, meaning you have to actually need the help. I am trying to be proactive due to insurance changes.

[Hidden]

Yes. However you have to qualify based on your income. .I am on medicare part d also and my co-pay is also 10,000 a year. However TOTAL family income is looked at .and total income includes your ira or 401 k mandatory withdrawals and pensions etc.. I don't qualify because of to much income. the leukemia society and the pan society offer 8-10,000 dollar yearly stipends to pay your copays. your pharmacy or facility should be able to do this for you

[12Caine12 in reply to Hidden]

"However TOTAL family income is looked at .and total income includes your ira or 401 k mandatory withdrawals and pensions etc." With this sentence are you referring to Plan D or the leukemia society and the pan society? Thanks in advance!!

[Hidden in reply to 12Caine12]

leukemia society and pan society. they use tax returns for verification-your gross income not adjusted income

[12Caine12 in reply to Hidden]

Thanks for your reply!

[vog292 in reply to 12Caine12]

My regional cancer group's pharmacy arranged thus far for the copayment from a foundation. They only asked for a verbal statement about my annual income which is $26 K and is consider "low" for the metrics. Thus this far the insurance and the foundation have paid for Imbruvica since 11 months. The insurance paid half and the foundation paid half. The insurance drug rx now fits me into the "catastrophic" classification.

[12Caine12 in reply to vog292]

Thanks for the reply. That is really wonderful. Are you responding well to the Rx? I'm pretty nervous, not ever having to take medications before.

[vog292 in reply to 12Caine12]

I am responding well to the Imbruvica, now one year treatment. There has been steady improvement. The only initial problem was a rash on the facial cheeks, which slowly vanished after daily application of ointment. It is important to have a good nutrition and excercise daily. Good luck ! You will be o.k.!

[Hidden in reply to 12Caine12]

If you have enough money for a family trust fund you can set one up and then your only income will be your mandatory withdrawals. If you are caught in no mans land over the maximum for help but under the trust fund money. You can give your spouse everything in a divorce and pay her rent.

If you are a single and have a trusted heir to what you do have can execute your will early and have your heir take you on as a dependent.

If your in the first group you are thankful that we enabled your stock portfolio to grow sans any thoughts to the external consequences of those profits.

If you are in the other camps your lack of involvement in what your politicians gave away to corporate lobbyists is now your downfall. Specifically the federal bills the prohibit government agencies like Medicare and the VA from negotiating drug prices. We contribute to charities that pay for funding overpriced drugs that also received both charitable donations and tax payer money for their initial research. Only to be taken private private. We get nothing for our investment and then have to pay through the nose for our medicine.

[skunkbay53]

Contact the PAN foundation panfoundation.org/index.php...

[12Caine12 in reply to skunkbay53]

Thanks for your reply!

[skunkbay53 in reply to 12Caine12]

PAN foundation also can give you other places to get grants for your meds

[LovecuresCLL]

I am in Florida. MD Anderson (MDA) billing department took care of working with my insurance company and the pharmacy (Diplomat). I signed a couple of sheets of paper on admission to MDA. I have never seen a bill for medication and I am on Gazyva plus Venetoclax. I have had 6-7 infusions of Gazyva and am on week 8 or 9 of Venetoclax pills. I am not on a clinical trial. I have a United PPO and I have never seen a pharmacy bill to date and it’s been months now.

The company Genentech that makes Venetoclax told me that if I ever needed financial help to call their “patient assistance program” and unless I made more than $180K per year or higher, they would help me, if my insurance wasn’t covering the “lion’s share” of the cost of the medication.

Honestly, it’s been seamless and low stress, so far. I have no idea exactly how much Venetoclax costs per month. My biggest expenses are the plane flights/hotels to fly/stay to/in Texas.

I will keep you informed, if anything changes.

Good luck and try not to worry as “out of pocket” may mean “lifetime maximum out of pocket” which has a different meaning altogether than what you are thinking. Billing is confusing and mysterious. You may get “preapproval” and the entire cost is covered. It is something that the cancer center has to worry about FOR you. It’s their job so I would call the billing department of the cancer center where you are being treated and talk to them which will allay your financial fears.

[Hidden in reply to LovecuresCLL]

I go to MDA. MDA does a very good job at handling insurance claims. They advocate for the patient which is a rarity.

[johnl]

Another source of assistance for Ibrutinib is Johnson & Johnsons Patient assistance Foundation. There are some income restrictions. You can call 1-800-652-6227 for more info

john

[jdolinger]

Morning 12Caine12

I live in South Carolina and am retired with a fixed income from retirement funds and Social Security. I have been on Imbruvica (ibrutinib) for over five months now). When I was first told that the cost of this medication would be slightly over $14,000 per month, I almost pulled the dirt in over my head then and there. However, from a good prescription drug plan thru United Health (AARP), I was told they would cover the first 80%. Doing the math that still left $2,800 copay. Fortunately, the Lavine Cancer Center Pharmacy in Charlotte, NC where I get the ibrutinib from said they could find me a grant that would cover the copay for the first six months and then do an automatic renewal of the grant thereafter. They told me the grant came from The Patient Advocate Network Foundation (PAN) panfoundation.org/index.php... My suggestion is find out who your drug will be coming from and see if they know if you can qualify for a grant also. Best of lucky to you.

Jack O.

[12Caine12 in reply to jdolinger]

Thanks for you reply!

[TimHB]

You may want to ask your CLL specialist about clinical trials. I'm in one and all costs are covered for the 3 years of the trial.