Would any MBC patients taking Ibrance please provide their typical monthly copay cost? My first two cycles were covered in full but not sure going forward. Would other patients please share info about their out-of-pocket cost and any tips on how to lower the copay portion? Many thanks!
What is your monthly cost for Ibrance? - SHARE Metastatic ...
What is your monthly cost for Ibrance?
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SeattleMom
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Funny you should ask! I was just told I need to pay 150.00 every January but the monthly cost has been $25.00. I have GHI/Emblem Health insurance.
I also have the same insurance but was just informed that when I turn 65 in March, the plan I have will not pay . I received a letter from my husbands union, dept. of sanitation that they will automatically enroll me in a Medicare part D progrAm which will cost me a great deal for the ibrance!! Any help with ideas for financial assistance! Panicking!! At 65 things should be easier not harder😢😢😢
Last year we were on Cobra because my husband retired. Pfizer copay was 10.00 then they lowered it to 0.00 for the last four months of the year. They notified me that it was staying at 0.00. Since cobra ran out they put me on Medicare. OH will not allow me to purchase a supplemental or secondary insurance. I also had to go on a Medicare prescription plan. They don't call it a copay, they call it coinsurance therefore Pfizer copay doesn't apply. My portion for January was going to be 2,561.00. Who can afford that. A patient advocacy company paid it this month. That's all I know.
You should have a max out of pocket with your insurance? I meet my annual out of pocket with January. It’s like 11k a month but my January copay was $4050.
my insurance gets billed over 23,000 for a 21 day supply
From Pfizer? Thought it was like 12k to the public without insurance. I don’t like discussing the financial costs of certain drugs on here. Every situation. Is different. Reach out to any and all organization that collects funds for cancer research, care, etc and ask for help
Thanks, Becky!
Search on Pfizer website for co-pays assistance program where you are..based on you health insurance you have..Hopefully, this will help.God bless us all.
I was blessed with being on financial assistance for six months. Now I have co-pays a large deductible. I could be wrong about the cost but I think I read somewhere that the cost is something like $10,000 a month, which most people can not afford. I will find out what I will need to pay by next month. I have insurance so much of it will be covered. My ex-husband is helping me some, which is another blessing.
Thanks for your reply, Susie!
I had medical assistance until this month. i am on day 21 on ibrance, with 7 days off of it. When I go back on it, I'll find out..
Pfizer itself has assistance. Go on their website. My own copay is 1600 in January and then drops to 200 and then to zero when I meet my annual max out of picket.
$40 co-pay
I pay $0.00 with the Pfizer copay card. I have medical insurance through my husband's employer, but it would have cost me $250 per month after hitting the deductible of $1750. You can go online and see if you're eligible for the copay card. I think you can get it if you have no insurance or insurance, but not Medicare. Last year I paid $10 with the copay card, then it became $0. That is correct, Ibrance costs over $10,000 per month; I could not afford to take it even at $250 per month!
Thanks, Bluebird!
I live in CA and have Kaiser HMO insurance through my employer. I pay $20 for each 21 day supply. My friend has Kaiser and is retired from AT&T and Ibrance was not covered. She applied for financial aid through Kaiser and she is getting it free for one year. Then she will have to apply again.
Thanks, Geri!
My copay was 16.66 but it was reduced to $10 with pifzer. I went on their website.
Hi SeattleMom - i am so lucky/grateful that for me my co-pay is 00.00 - under my plan oral chemo drugs have no copay. Now i do have a high deductible plan so i have plenty of other things i have to pay for.
Oh I have United Health.
I went to Pfizer.com and signed up for their discount card of $10/month because I have a $5000 yearly deductible.
my copay is $185 a month but thru my provider I got on a program that the pharmaceutical company has and pay $10. I haven't gotten January yet so not sure about this year
I have a co-pays of 200 for a 21 day supply. My pharmacy said it's 11,000 for the 21 days . Hope this helps😊
Hi SeattleMom,
When I was on conquer-magazine.com website, I saw an article about which drugs we're used to treat breast cancer and then it listed if and where financial support could be obtained. Most of the drugs do have some if not all financial assistance.
I hope this helps.
Blessings, Kate
I was on ibrance for 2 yrs. until recently. 2 months ago it spread to my stomach so I'm back on abraxane and xeloda for 6 months. I was paying 100.00 copay. I also get disability. Did you know that mets breast cancer patients qualify for disability? I live in WA and have been receiving it since 2013 when I was diagnosed. It's easy to apply online. It helps with costs.
Thanks for the info, Cindy! Did you apply for the disability via a website in Olympia? That is a great tip for all MBC patients; I really appreciate it, as I can see that the Ibrance prescription can start getting very expensive, especially when you are retired and on Medicare. Hope your new treatment is going well. Bless you!
Hi SeattleMom
Here is the link to apply ssa.gov/applyfordisability/ Scroll down and you'll see the blue highlighted link "Apply for disability" I have HMO preferred insurance, by the way. Every little bit helps. Take care!
Thanks so much, Cindy, for all of the info! Blessings to you!
You're welcome! Take Care!
Before I was diagnosed MBC I took an early retirement and collect my pension & SS. I am assuming disability isn't in addition to what I receive. I also read there is a 2 year wait time to get Medicare w/ disability. I get Medicare in 2 years anyway.
He SeattleMom! Regarding Applying for disability, how long is the waiting process? We have to be off work for a while right?
Hi Theresa. I’m not sure of answer to your question. You might post as question to group. Someone else likely has the answer. Good luck!
I’m in WA too and I am also receiving social security disability monthly.
That Ibrance commercial with “Julie and her new normal” cracks me up!! She goes off to her job at the college with a bunch a germy students?!?!?
How is that even possible??
LOL!!
For SSD, stage four BC is almost automatic for benefits. I’m 63 and the benefit is almost as high as if I’d waited til 66 for regular SS...and I think it isn’t taxable.
I suppose I should go to SS security office and see if it makes much difference. One calculator i used came to pretty much what I receive now as early retired. I read that there is a 2 year wait time to get Medicare on disability... which is my wait time anyway at almost 63 now.
Don't know if you checked it out yet but there is virtually NO wait time for Stage 4 Medicare applications. Mine was approved in under 3 weeks.
Are you already 65? My understanding is that if you’re, say, 60 with MBC and on SSD, there’s just a two year wait for Medicare instead of Five. Since I was 63, there was no advantage. And my insurance coverage of Ibrance is better on my more expensive retiree insurance than it will be on Medicare in June. That has me worried. I’ll probably get Part F while it’s still available.
That is correct. I used Cobra until my medicare medical coverage began, however, the disabil8ty payments started in 6 months i think.
It IS taxable
Yes, that commercial makes me wonder also. I did an early retirement one year ago. I've pondered what path would I had taken if I kept working. One thing for sure 'no way' could I navigate all day in a busy art room with side effects like needing to use the bathroom a lot. I schedule my day with outings in the afternoon just so my bathroom routines are taken care of.
Great marketing! We know that isn’t possible!
I really admire anyone who can work while on Palbociclib. Currently, I don’t see how it is possible. Maybe I’m still recovering from chemo and radiation?
I'm working full-time as a nurse in Labor and Delivery and doing fine.
That is great! I am also a registered nurse and realize only too well all of us are different and there are many variables. I haven't worked since my stage 4 diagnosis. 16 years ago when diagnosed with stage one I went through IV chemotherapy, multiple surgeries, radiation therapy and was hospitalized for severe MRSA infection. Other than first 4 months of that I worked full time, 12 hour shifts in inpatient pediatric acute care and PACU. Fast forward 16 years and I'm just not able to do that this time around.
I’m on Ibrance for a year and a half and work full time as a fifth grade teacher. In the beginning I had joint pain, but feel fine in it. I’ve changed my diet to being vegan and drink alkaline water. Im tired but actually feel pretty good.
I am a college professor and I have been taking Ibrance (and have continued working and teaching) for two and a half years. I, too, have seen that commercial---and thought, "Oh, look! This commercial is exactly my story." I wondered if I was going to be vulnerable to catching a lot of colds and cooties but, in all this time, I have been fine. I have been on the top dose of 125 mg + Letrozole and have not even had problems with neutropenia. (I am overweight and have wondered if that's why I have been able to tolerate the highest dose.) I have goos Blue Shield insurance through the university and pay nothing for Ibrance.
very funny but true!
I have MBC, diagnosed in Feb 2015. I have been on Ibrance since March 2015, just a few weeks after the FDA fast tracked Ibrance approval due to its success in clinical trials.
I applied for Disability, and yes, MBC is an almost certain acceptance for social security disability. What a relief! It is not what i could earn if i could work, but we made some changes and so far we are getting by.
My concern is what does Medicare cover on the Ibrance? I'm still on my husbands commercial insurance plan, it has a large deductible but there is a Pfizer assistance plan that picks up the cost of that deductible. I am told that there are no such discounts if Medicare is your primary/only insurance. It is illegal for the pharma companies to offer discounts to Medicare patients. Is there anyone else who has Medicare only that can share their experience? By the way, current cost for Ibrance is $11,000 per month!
I have Medicare and part d supplement. I did get financial help last year for about 6 months. - then co-pay was about $589.00/month. Not sure about this year.
I will be starting y Medicare on March 1st and have been looking for a part D plan that is a affordable so it can assist in my ibrance coverage. So far the deductible and co-pay are not so bad but the cost of the meds are crazy!!! Can u share which plan h went on. Up until now I was paying $25.oo per month on my husband’s plan but it will not cover when I go on Medicare!!! This is a legal crime!!!!!
I'm on Medicare and have a Part D plan thru Mut. of Omaha for prescriptions. It is the "G" plan which covers everything except the annual Medicare deductible. Pfizer does not give the coupons or discounts for Medicare patients or Medicare eligible patients. I pay a lot in January - about $3,000 in 2018 and I think it may be about $2,300 for 2019, because of the "do-nut" hole closing. It'll be about $600 a month thereafter assuming that the monthly retail charge is $12,000. I've heard that they will be raising it but don't know yet the amount. Medicare wants you to have "skin in the game" and therefore makes you pay 5% of the cost after the first $5100. Pfizer tells you to go find a charity which is really hard to do because the charities restrict you to 4 to 5 times the poverty rate for single people - that would be helping only those making less than 48 to 60 thousand a year. At $600 for 12 periods and the $2,300 for January, it comes close to $10,000 a year for the one drug.
I have BCBS ins, my copay would have been $50 dollars, but used my new Pfizer discount card and it being delivered on Friday with a $0 copay. Finishing cycle 9.
Well, if you got it free for the first two months, you are a lucky lady. Researching, If I were NOT on medicare, i would be paying $250 per month. On Medicare, it will cost me, my copay, $13,000 a year. AND, I have the top medicare program, top drug program and top supplement program!! That is what I have to pay starting next month. something is wrong with this picture!!
Hi blms,
You wouldn't be paying $13,000. in a co-pay on Medicare. If you have a Part D insurance plan you will pay up to the yearly amount (which I think is about $4500. sorry can't remember)) the first month which puts you in the "catastrophic" level and then your co-pay should be 5% of the cost of the monthly drug. Look at Tier 5 information on insurance information. Now, depending on where you live, you might be able to get your Ibrance through a Speciality" pharmacy (CVS has them) where they often will pay part of your monthly amount (including your first month). Ask your oncologist if there is one near you. I find the information for Tier 5 drugs almost impossible to navigate when applying for Part D insurance. That is what drives me crazy as I can't get the information I need to make an informed decision about which insurance is best with a Tier 5 drug using a Speciality Pharmacy. I paid $2994.25 for the first month which is breath taking expensive but I am lucky that I have savings that I can use. My 2nd amount will be less but I am not sure what it will be. I was on Afinitor for 3 years and after the first month it was close to $800. The other thing you need to know on Part D Medicare for Tier 5 chemo drugs is that they go up every year. Some, maybe not so much. Infusion therapy is totally covered under Part B.
If your income is less than $80,000. (it might be higher this year...not sure) many of the drug companys have assistance as well as the insurance company's. If you are on Medicaid I believe you will be covered also.
Hope this information helps!
Yes, I am aware of how the Medicare D program works but the problem is--Ibrance costs $15,000 a month and 5% of that is $700 a month after I have paid the 2018 new pricing for Medicare to put me into the catastrophic stage of $5,000. That brings my copay up to a minimum of $12k to $13k spending for the year as the pricing is different with different pharmacies. There has to be a better way to help with copays other being under income. If our household income was $80k in the Washington DC metropolitan area we would not be able to live here. So, why is it that some people have to choice between paying their mortgage of their cancer drugs. Something is wrong with this picture that these drugs are so inexpensive before Medicare and so expensive after going on Medicare.
Ibrance is 11500 through my specialty pharmacy...not a lot less, but you should shop! Expressscripts...
Same here - I use SilverScript as my Part D insurance and CVS Specialty pharmacy. My prescription cost is $26/month - there is no annual deductible.
I'm just beginning this process this month and the costs are staggering. I will be on medicare come January and am overwhelmed with decisions that need to be made. Who is your provider for Part D with the 5% co-pay? I am finding much higher co-pays than that. Thanks for your help.
I use SilverScript (I think it's owned by CVS) and there is no deductible. The 5% co-pay is a Medicare mandate to make you have "skin in the game". That is only after you have reached the catastrophic level which will be $5100 in 2019. It is 25% of the first $5100. That amounts to $1275 plus 5% of the excess over $5100 for January. If the cost for Ibrance is raised to $12,000 every 4 weeks (which I've heard is happening, but cannot verify) that would be $600 X 12 plus January. It is complicated, but I did find a Part D calculator on line which allows you to put in all your own details to come up with an approximate amount. It did not differentiate between generics and namebrands and instead made assumptions so it's not perfect but I understand that namebrands are no longer subject to the donut hole this year so the amount may end up a little less than the calculator. Just google "Medicare Part D calculator 2019". Hope this helps and doesn't muddy it up. We really need to make cancer drugs fall under Part B.
I am in the same mess you are in - and believe me I have looked for help but none out there -I will be paying over 1000.00/month. Pfizer will not negotiate with government programs such as medicare and I make too much money to be classified a hard-ship case. Any suggestions out there for the middle-class mess!
Check with your oncologist. Ask him/her to intervene on your behalf. Mine did just that, and now I just call Pfizer once a month to order next month's supply--all free of cost. I think Pfizer will respond much more readily to a medical professional than to the poor patient! 
Linda XO
Pfizer CANNOT legally offer free or discounts to Medicare patients. It's not allowed by Medicare and would be fraud.
When I thought the ACA would be repealed, I called Pfizer. They said they would make it work for me. I wouldn't be without. I am on disability now but it is not enough for the new York metropolitan area so I am going back to work. Looking forward to an NED life.
Good luck and Godspeed on this journey, Meadesmith. Please check into this financial assistance program: Patient Advocate Foundation, Co-Pay Relief, copays.org
I have been approved for the Pfizer copay card and I have been approved for 2 years cost free. Contact Pfizer to see if you qualify. I would have never known without my oncology nurse sharing the information with me.
It is interesting to me how the cost of Ibrance varies—let alone all the permutations of INsurance and copays. My Ibrance through accredo specialty pharmacy is listed at about 11500. I paid 1500 in January, 200 in Feb and March, and then having reached my max out of pocket, I now pay nothing for the rest of the year. I’m a little worried about choosing a Medicare plan (June ‘19).
I'm on Medicare and had free access to Ibrance (under special funding available through pharmacy) but have now begun to pay approx 250-300/month. They have also advised I apply to pfizer directly for some patient compensation availability. Given that a monthly supply is supposedly over $10,000, anything under $500 is a gift, IMO. Hope you are doing well, Buffwright! XO Linda
Pfizer has a copay assistance program. It knocked my 300 a month copay down to zero. It is not based on income. You can apply online. It doesn't even require much info. My pharmacy even applied for me as well.
Thanks so much, Lisa! I'll definitely give Pfizer a call! Hope you are doing well! XO Linda
Most drug companies offer a similar copay assist program. Anytime you wind up with a large copay it is worth looking into. Let me know how it works out.
It son't deal with medicare so this only applies to people who have commercial insurance
Hi, Lisa! Sorry it took so long to reply. My onc contacted Pfizer and my Ibrance is now covered in full. Yippee!! Linda XO
YEP ON MEDICARE YOU GET SCREWED
Who is your Medicare Part D insurer? Contacting Pfizer has nothing to do with Medicare or your insurance company. Your oncologist should be able to contact Pfizer directly to get this med covered for you! Be sure to ask!! Linda
Right about that oncologist can make Ibrance free no matter what if they do choose
Stage 4, Breast cancer mets to bone. On IBRANCE, FASLODEX, XGEVA., Moving to Oregon in a few months. My insurance will not transfer. Any suggestions on this? I will be on ssi disability. Any info greatly appreciated.
Oregon is a state with ACA options, so that should help. With SSI disability, don’t you qualify for Medicare right away? (I have regular SS disability and there’s a two year wait for early Medicare if you’re under 63). Oregon is a state with ACA options, so that should help, in any case. Good luck! ....I may eventually move to Oregon. My daughter is there.
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