Besremi doing well

[Manouche]

« Sales of the drug are better than expected »

[kristinmarie]

Of course, the sales grew well. The company asked the user to junk some $6000 worth of the drug prior to every use. This is certainly not common practice in the U.S.

[hunter5582 in reply to kristinmarie]

It makes me cringe every time I waste 80% of the syringe. I met some of the company reps at the MPN conference last week. PharmaEssentia is working on the dose titration issue. Some sort is issues with FDA need to be worked out re. the delivery system. Hopefully we will be able to stop wasting so much of an expensive drug before too long.

[Meatloaf9 in reply to hunter5582]

Hi, it just doesn't make sense to waste so much of the drug. I read somewhere, maybe here, a post that said they were given the syringe and 10 needles so that they could change the needle and reuse the medication. Is that a possibility? I know that people use a multi dose vial for pegasys when they are supposed to only use the vial once but can get 4 doses out of a 180mg vial. I assume Pharma Ess would not like anyone getting more doses out of a syringe, would hurt their bottom line. Thanks for posting.

[hunter5582 in reply to Meatloaf9]

We can only hope that a modicum of ethics will prevail. I think all of us who are taking Besremi need to provide that feedback to PharmaEssentia. Not sure how much it will help, but squeaky wheels are more likely to get greased.

[GardNerd in reply to hunter5582]

@hunter5582: I was following the four month old post yesterday (just joined the group) and am glad to see you got on Besremi. I'm just beginning the appeal process with Caremark. They want me to fail on Jakafi first. Is Besremi worth the fight? Given the cost difference, I'm thinking they may approve me for Pegasys. I hope you're doing well!

[Meatloaf9 in reply to GardNerd]

Hi, I'm no hematologist, but I think that Besremi is a first line drug for PV and Jakafi is a secondary line drug for when the others fail. My thinking is that I would want the besremi first and save the Jakafi for when/if I transition to MF. I don't think the besremi helps much for MF but Jakafi is a first line drug for that disease. Just my thinking, best to follow your mpn specialist's advice. Thanks for posting, let us know how it goes. I don't know which is more expensive, besremi or jakafi??

[hunter5582 in reply to GardNerd]

If cost is the issue, then it makes little sense to require you to try Jakafi first. There is little difference in the cost. Jakafi Approximate Retail Price $14,308.00/month (60 caps - all doses)

Besremi Approximate Retail Price $15,000.00/month (2 prefilled syringes).

You are correct in thinking that Pegasys is less expensive than either other option

Pegasys Approximate Retail Price $4,208.00/month (4 vials) or $4,177 (4-syringes)

Assuming they are willing to approve Jakafi, cost must not be the issue, It may be that the Caremark authorization folks are just not up to speed on the newly authorized Besremi. This is part of what I ran into when I had to file my appeal. You may have a successful opportunity for an appeal if you wish to pursue one.

Jakafi is a viable and very helpful option for some people with PV. Based on your symptom profile and overall medical profile it could be a viable option. Whether Besremi is a better choice is based on your treatment goals, risk tolerance, and preference's. If your treatment goals include choosing the medication that is the most disease modifying (chance for molecular remission/decreased risk of progression) then one of the IFNs may be a better choice for you. This is something to discuss with your MPN care MPN team.

It is up to you to decide if it is worth appealing. You could also opt for Pegasys if you wish. I chose to start on Pegasys until Besremi became available. If you do decide to appeal, then you need to understand how your Caremark plan works. the first step is to call the appeals department and request a copy of the Plan Rules. These rules drive the decision making and it helps to mount an appeal if you understand the rules. Your doctor can do a first step in the appeal process, but likely does not have the time to do the research into every patient's plan. I filed my own appeal for the Besremi. It took 14 hours of phone calls and a lot of persistence. I did prevail. This is actually the second time I have had to file my own appeal for a medication. Both times were successful.

Hope that helps. All the best.

[EPguy]

They can take that to the bank as many of us pour the $ down the drain. As Hunter says, we can hope the official procedures get more practical.