Ocrevus focus day 4: Thanks to everyone... - My MSAA Community

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Ocrevus focus day 4

greaterexp profile image
21 Replies

Thanks to everyone who has been adding their comments and answers during this past week. Today's questions deal mainly with the ugly side of treatment - money!

Kindly number your responses.

1. How did you/your doctor begin the copay assistance process and how long did it take?

2. What are your out of pocket expenses associated with Ocrevus?

3. If under NHS (National Health Service), how long did approval take for Ocrevus? Have there been any delays or problems with continuing your infusions due to bureaucracy ?

4. What kinds of routine monitoring (e.g. labs, MRIs, physical exam, etc.) does your doctor perform prior to infusions?

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21 Replies
CalfeeChick profile image
CalfeeChickCommunityAmbassador

Great questions, I’m not on a DMT yet, so can’t answer. 😊👍

jimeka profile image
jimeka

I have no idea. Apparently the NHS will be given the go ahead in June to implement Ocrevus for PPMS patients. My name has been put forward by my nurse to my neurologist but there are 15000 to deal with, so I wait.

Ali_B62 profile image
Ali_B62 in reply to jimeka

Hope you won't be waiting very much longer! ☺

erash profile image
erash

1. Idk, I called Genentech and they got me on board

2. Infusion center copays for oncologists, labs, infusion center services

3. N/A

4. MRI yearly, complere blood count with differential, comprehensive metabolc panel, and just added CD19 (lymphocytes) yearly —along with T-SHIRT, 25 OH Vitamin D, B12 not assoc. with monitoring Ocrevus

Lilith08 profile image
Lilith08 in reply to erash

T-SHIRT or TSH?

erash profile image
erash in reply to Lilith08

🤪 TSH

Lilith08 profile image
Lilith08 in reply to erash

Hahahaha! 😁

Iona60 profile image
Iona60

1) After googling, I contacted Genentech and began the process and it took just a week or two for approval.

2) Prior to medicare- Less than $250 for infusion administration and non Ocrevus meds like benadryl and solumedrol. Note: Per advice from MS society, infusion administration costs are much lower at free standing infusion center than at a hospital. Next infusion will be after medicare - Hoping for minimal cost.

3) NA

4) Lympocyte panel one month prior to each infusion and annual MRI.

Elizt3 profile image
Elizt3

1. The Genentech representative helped me.

2. Ten dollars for each half dose. I had a 400 dollar copay. Copay assistance paid 390.

3. N/a

4. I’m having the first “baseline” MRI today. CBC, thyroid, cd19, b12, cmp.

Juliew19673 profile image
Juliew19673

One of the fastest for approval. DXED ON 5/15/18 infusion 3 weeks later.

First infusion they ran a plethora of blood work and none since (have had 2 infusions since).

For the copay "help" Genetech had me jumping through so many hoops it was obnoxious!

My OOP was $70.

carolek572 profile image
carolek572CommunityAmbassador

1. About 12 weeks. 2. Should be $5.00 per infusion because of the co-pay assistance program from manufacturer, 3. Not applicable. 4. Blood work

I go to the VA for my treatment I find out July first if I will have the Ocrevus treatment.

rjoneslaw profile image
rjoneslaw

1 insurance covered it 1st request

2 insurance full coverage

3 1st request covered right away. 1st half infusion june 25 and 2nd half july 19

4 had to have hep b test that's it.

kycmary profile image
kycmary

1. Drs. assistant put me in contact with Genentech.

2. Ins is taking care of it so far.

3. n/a

4.had base line M.R.I. to start, blood work checking for hep B & some other stuff. Repeated the same just before the full dose.

kycmary profile image
kycmary

Sorry I did not find the first 3 questions!!

Allen5280 profile image
Allen5280

1. No copay assistance on Medicare as primary and Medicare as secondary (Medicare extra help)

2. No out of pocket

(I had to exaust my own resources on prior health care to Ocrevus.)

3. NA

4. Hepatitis B screening and now just my normal labs. My labs come back perfect every time around due to all the changes I've made over the years and other than a CBC I dont know of anything in particular for pre infusion screens.

ahrogers profile image
ahrogers

1- I started on clinical trial which was free then when trial was over I happened to move right after my last trial dose was over and had to establish with new neuro. I was scheduled for my first Ocrevus for less than a month after being seen by the neuro as I was already delayed because of how long it took to get in. I don't remember exactly how long it took to get approved for copay assistance but I would guess less than 2 weeks. It was a very easy process.

2- my insurance has a $5600 out of pocket per year and I had already incurred some out of pocket costs before my first infusion last year but this year I had the infusion mid January and they paid $5500 leaving me only $100 to pay. It was great because I needed a hysterectomy at the end of January and my out of pocket was already covered.

3- n/a

4- blood work 2 weeks before and 2 weeks after. My current neuro doesn't routinely do MRIs every year. I am seen twice a year but not necessarily before my infusion. In January I saw the PA the same day as the infusion but after I had it so was kind of a waste of time since she couldn't really assess me after having the Benadryl and steroids. I get my next infusion at the end of the month and see the doctor in the middle of July

hairbrain4 profile image
hairbrain4

1. It took about 3 months before I was approved.

2. Out of pocket costs are about $35.00.

3. Not on NHS I have disability insurance that pays for part of it, Gentec covers the rest.

4. Dr. runs routine chem panel & metabolic panel every six months.

bavery207 profile image
bavery207

1- I do not have a co-pay.

2-I have no out-of-pocket expenses.

3- NA

4-My neuro. orders blood work for me 4-6 weeks prior to infusion, and he also schedules an appointment to discuss blood work/up-coming infusion.

kdali profile image
kdali

1. I didn’t ask for copay assistance

2. None that I’m aware of. I’ve asked my husband twice if we ended up with a bill for it, and he said not yet. We had to pay a lot for the MRI months before the infusion, so that may have been a factor.

4. I have an annual MRI either way. She wanted one at the 6 month mark because I was intending to be pregnant and you can’t have contrast during pregnancy. I have an exam 4 weeks after the infusion. My OB ordered a baseline 3D mammogram before I started and I’ll have another in 2 years, despite not having a breast cancer history in my family she felt it was prudent.

RenaeWhit profile image
RenaeWhit

1) Drug company phoned me to set up co-pay process.

2) My OOP varies with where I'm at in insurance cycle, but my annual OOP max is $5k.

3) N/A

4) Blood work up 2 weeks prior infusion and at 1 and 3 months post infusion. Annual MRIs.

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