Ibrance expensive

[worldtravel75]

How do you guys pay for Ibrance? I start Medicare in january and phizer won’t give discounts to Medicare pts. They are upping my monthly drug prescription part D to 1000.00 per month because of this drug.

[PLASEM]

I do not have Medicare but My advice is talk to your doctor and social worker They can find places where to find financial assistance, did you talk to Phizer probably they know how Medicare patients get financial help for you medicine take care and God bless you

[Sister3nkc in reply to PLASEM]

I am following this post as I am in exact same situation. My husband is past due to retire, he is almost 67. We want him to retire in December and I am so worried about how we are going to pay for my Ibrance. I have been on it for over 5 years as I started on it just after it was approved by FDA in February 2015.

Who would think after a lifetime of working, paying taxes and contributing to society that we would be faced with such catastrophic expenses to stay healthy and alive? There is really no way to have planned for such a thing.

God bless you and good luck. Would love to hear from you and know if you figure anything out.

[PLASEM in reply to Sister3nkc]

I know it is hard thinking of all changes when you retire, I do not have the age to qualify for Medicare, my husband retired and He has Medicare and only covers 80 percent and for us having scans medications it is going to be expensive so either have supplemental health insurance I am on short term disability then retired from my job and I will apply for social security disability but it is so hard to do all these applications when you are not feeling good, take care

[worldtravel75 in reply to PLASEM]

I e come it all but thanks for thinking of me

[worldtravel75 in reply to worldtravel75]

Bad typing above. Thanks to you both and I will let you know but so far I have tried everything as has the hospital without luck. U of M said they would pay for 1month while I keep looking so that is good. Scans in 2 weeks - if not working I will be changed but all the other drugs are just as expensive.

[JBirdnut]

Your oncology staff should have info on getting a grant from a foundation. It is very late in the year, so there may not be any grants available right now, but come January, there will be.

I got assistance from Ochsner Specialty Pharmacy. I called them when I first found out that I would be taking Ibrance and that my co-pay would be outrageous. They were able to find me a grant that paid my whole co-pay (Humana paid their part). That was in January of this year.

It is my understanding that the drug company will allow you to pay just an acceptable copay as long as you have medical insurance to pay their part.

The foundation my grant came from is PAN (Patient Advocacy Network).

Best wishes to you. I hope you can find some help. We don't need the stress of the financial burden when we are dealing with MBC.

Janine in Folsom, Louisiana

[worldtravel75 in reply to JBirdnut]

Thanks. Checked with PAN and they won’t deal with Medicare which. is what I will be on starting in January -retiring in December -in fact -Phizer won’t help at all with Medicare insurance just commercial. Have a call in for the oncology social worker to see if she can help

[JBirdnut in reply to worldtravel75]

All you will have is Medicare? You have not applied for a supplement such as Humana, United Health, etc? They will honor those insurances.

[ArizonaGramma in reply to JBirdnut]

With regard to this comment...I have Original Medicare, a supplement through Colonial Penn (plan n) and a supplement only kicks in for Medicare approved expenses to help cover the part that Medicare does not cover under A and B.

I have a stand alone part D through Humana and they did not cover Ibrance. I contacted Pfizer, got an application that is filled out by myself and my oncologist office. My approval for full payment was based on my income and my husband's and we are both on Social Security and Original Medicare.

[worldtravel75 in reply to ArizonaGramma]

Thanks for info. I am afraid I am about 6000.00 over their limit but I will contact them and make sure

[worldtravel75 in reply to JBirdnut]

Are you on Medicare or commercial insurance. I would be able to get lots of help with commercial but absolutely no help when on a Medicare prescription plan😟

[JBirdnut in reply to worldtravel75]

I have more than just Medicare. I have a Humana Advantage plan which includes a Part D drug plan. With that, I was able to get a grant thru PAN since the Humana Advantage plan paid their part of the Ibrance monthly cost. The copay was very high when I tried going thru the Humana Specialty drug pharmacy. They tried to get me a grant but didn't come through for me.

It sounds like you don't have a supplement insurance, like Humana or many others. You need one of those in order to have "commercial" insurance that PAN will accept.

I didn't go to the drug company for help, but I was told that they will help if you have insurance like Humana Advantage, People's Choice Advantage, etc. I am certainly no expert, just using my experience to answer your questions.

[worldtravel75 in reply to JBirdnut]

thanks for info - I do have a united health care supplemental policy but as soon as I put in Ibrance to apply for my part D pharmacy card - 1000.00/month pops up. Maybe I will call then next week

[JBirdnut in reply to worldtravel75]

The only difference I see between my insurance and yours is mine is an advantage plan which includes a part D. Maybe that is why PAN accepted my insurance?

With the PAN grant, my copay was $550.00 per month which the foundation paid. Again, I went through an Ochsner Specialty Pharmacy person who did all the paperwork for me. A real life saver for me.

My Humana Specialty Pharmacy was not as helpful as the Ochsner Specialty Pharmacy. The copay thru Humana was way over $1000 per month without any grant help. They said there were no grants available even though I qualified.

It seems like someone in your onc's office could help you through this very difficult time.

One more thing, getting a grant isn't just for poor people. But you do have to give them a copy of your last year's 1040. There is a maximum income that you have to be under.

Best wishes in the Ibrance.

[worldtravel75 in reply to JBirdnut]

thanks - I will check advantage plans - your info was very helpful. I am over the maximum income for this year cut I worked. It will drop next year because I am retiring in a couple of weeks

[JBirdnut in reply to worldtravel75]

Retirement is great. I hope you can get everything worked out to a satisfactory outcome.

[Purple60 in reply to JBirdnut]

Just to clarify as patients are often misinformed....it is not the drug company collecting or demanding the co-pay, it is our insurance companies. The drug company sets a price and then the insurance companies set the co-pay amount. It is a very odd process but for these expensive medicines the drug companies provide the discounts on price which then in turn are honored by the insurance company. Not an easy process to understand.... so the advice to speak with our insurance companies once the drug companies end discount programs is probably the best route. Good luck to you!

[worldtravel75 in reply to JBirdnut]

My PAN foundation grant just ran out but they have no more available money

[Formersnowbird]

I have Medicare supplemental insurance and Medicare part D. I paid close to $3000. for my first month and close to $600. every month since then. I was told my income was not low enough to qualify for aid. Guess I will continue to use my savings until they are gone.

[ArizonaGramma]

I am Original Medicare and so is my husband. What you heard is not true. There is an application that is filled partly by you (proof of income, ss annual statements) is required. Approval was based on level of income and your oncologist has an area to fill out regarding your type of cancer and your previous treatments thus far. My Humana did not cover it either, it would have cost me $2200 a month.

[worldtravel75 in reply to ArizonaGramma]

I think I am

Over the income level but will get it clarified.

[PJBinMI]

Depending on your age and income, you may be able to find good supplemental insurance that you can afford. I was diagnosed the month of my 57th birthday and had medical insurance thru my husband's employer. When I went on Medicare at age 60, that insurance became supplemental and we had good coverage, When I turned 65, I switched supplemental plans to my last employers plan and my husband switched, too, when he turned 65. I have heard good things about the AARP supplemental plan thru United Health Care. My employer provided supplemental is thru UHC, too, and I have found them easy to deal with. You must be 50 to join AARP and I don't know how old you have to be to get the UHC plan thru them. I've had friends with mets who have had that plan and have been pleased with it. I think I paid $35 a month for Ibrance when I was taking it for few months. It did nothing positive for me but the insurance was good. I hope you find a way to get the meds you need without breaking the bank!

[charlie1712]

Apply for financial help through Pfizer. I did mine through my onc insurance dept; am on Medicare; must apply each year; dosage was 125 Mg; did mine for 2 years until my med protocol changed. Blessings to you and all on this journey. Charlie1712

[worldtravel75 in reply to charlie1712]

My income is over their limit

[Hidden]

I have looked into this a bit and was told with the best part d (pharmacy) available I’d have to pay about 10k a year. I’d pay the first copay of $2300 and then fall into the “donut hole” for catastrophic care and be liable for about $500 month. Not nothing when you don’t have a pension or pension benefits. Doesn’t include price of pharmacy plan. Why wasn’t I smart enough to retire from a government job?

[Sister3nkc in reply to Hidden]

That is exactly what we were told also.