For all of you on Besremi how do you pay for it? Does your insurance pay for it ?
Or Medicare? It’s such an expensive drug ?
sorry if this is too personal or if this has been answered before.
I am not on Medicare yet and I am not insured on a company plan unfortunately. I have a local oncologist/ hematologist and I go to MD Andersen once a year with Dr Bose. (I am fortunate to be in the Houston area.)
I pay $100/month for Besremi on my Medicare Part D plan that is managed by Cigna. This is a former employer sponsored plan available to retirees. There is also a $2,000 annual cap, which is always reach with all the various meds I take. I could never afford the higher co-pays many people face. Besremi costs about $14,000/month. I consider myself fortunate.
While I am fortunate to have a good plan, there have been challenges. Initially, my plan denied Besremi, when it was just approved by the FDA (not on formulary yet). It was a major battle to get it authorized. I had to be the one to file an advanced appeal. More recently, it was denied but easily appealed. I did not have to get involved this most recent time.
There may be assistance available to you if there are problems accessing Besremi. You can contact PharmaEssentia Source for assistance. pharmaessentiasource.com/hcp/
All the best
Hunter thank you for replying to so many of us! I hope Besremi will come down in price at some point.
I expect it will be some time before Besremi cost comes down very much. The good news is that there will be a $2,000/annual cap for everyone on Medicare Part D starting in 2025. This should help many people.
Or why even bother with Besremi when Pegasys is this much cheaper: imagizer.imageshack.com/img...
I pay zero for Besremi. I'm on Blue Shield Medicare PPO. Prior to being eligible for medicare I was on a commercial plan and it also paid for Besremi for one year. The second year they took it off their formulary but it worked out as I had to transition to a Medicare plan through my husband's former employer.
my oncologist worked very hard and I qualified for free drug for a year. Tricare says hard no that they will not pay for it. I am going to add commercial insurance this year with my tricare and fingers crossed it will pay for. I was amazed I qualified for free drug as me and my husband have decent jobs but $17,000 a month, no one can afford it!
Happy for you to get free drugs! May I ask which program did you enroll? Are there enroll limitations for patients who's on Medicare or other subsidized insurance program? Thanks!
I enrolled through pharma essentials the drug company itself. Usually there are restrictions, but I am on tricare and it is government. So, you could try. Worst they could say is no. And the drug company is easy to get a hold of and they are super helpful. You could call them direct and just ask.
I haven’t had to pay anything. Through my MPN specialist and a specialty program with the pharmaceutical company- I also get it free for a year. That year is about to be up. We’ll see what happens then.
I have Medicare plan D also but last month was my first month and my co pay was $2600. Just ordered my second and it was $2400. I am now in the donut hole so should go down. Yes, it’s extremely expensive. There are several programs as Hunter pointed out which we didn’t qualify for but you might. Hopes the price will come down soon.
MD Anderson is the wrong place to go except for rich people or those with exceptionally good insurance. They have stratospheric prices for lab tests, office visits, etc., and insist on prescribing the most expensive medicines.
They probably didn't tell you Pegasys interferon is 3-4 times less expensive per month and just as effective: imagizer.imageshack.com/img...
The way to afford Pegasys if you are under 65 is to enroll in an Obamacare health plan that will cover most of the cost and then get a $10,000 grant from the PAN foundation to cover the cost of the monthly co-payments.
The way to afford Pegasys if you are 65+ is to enroll in a traditional Medicare and a Part D drug supplement plan. Then you will also need to get a $10,000 grant from the PAN foundation to cover the cost of the monthly co-payments (if your retirement income is less than about $70,000 a year and you are single.
I would tell Dr. Bose you want Pegasys and if he won't cooperate go to a non-MD Anderson cancer center like Texas Oncology.
Interesting comments . I go to MD Anderson and they have me on Hydroxyurea and said if I want to try Pegasus I can. I haven’t had any issues with HU I thought but I have many other medical problems since diagnosed with ET so it’s hard to know if the HU is still not causing me issues. Don’t know what to do and I don’t want to pay for Pegasus. I have Medicare part D and Mutual of Omaha supplement. 🤷♀️
I also have Medicare part D and Mutual of Omaha supplement. A $10,200 annual grant from the PAN foundations pays the monthly co-payments for Pegasys interferon and also covers the donut hole. So I pay nothing out of pocket except the premiums for the supplement and Part D plan.
Here's a look at the vital information MD Anderson in Houston should be telling their patients, but they don't.
The Silver MPN Center in New York City treated 470 PV patients over a 30 year period and this is how the outcomes of those patients differed depending on treatment:
20 years after diagnosis:
95% of PV patients who had been treated with interferon were still alive and 15% of them had progressed to post PV myelofibrosis
63% of PV patients who had been treated with hydroxurea were still alive and 41% of them had progressed to post PV myelofibrosis.
57% of PV patients who had been treated with phlebotomy-only were still alive and 49 % of them had progressed to post PV myelofibrosis.
I have been to MDA several times and they are more than willing to talk about treatment plans and stats like you presented. If I wanted Hydroxyurea they would have prescribed it. My original question was not about MDA it was how were people paying for Besremi. It seems like you didn’t have a good experience there. Best of luck to you.
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