Cost of ibrance

[Jhshl512]

I’m new here. I have had mbc for 8 years now, and was prescribed Ibrance this January. I just paid $2500 for my first copay of 21 pills. My oncology team tried to get me financial help but was told every time that my husband and I make too much money. I am a disabled secretary and my husband is retired. I’m told there’s nothing any one can do. I have Medicare, blue cross and a pharmacy plan. By the end of this year my copays will be $12,900. So upsetting! I guess I just wanted to vent. Good old American healthcare. Just awful! Not only do I have to deal with mbc, but I have to worry about how to pay for it!

[Lna21]

Hello I am sorry the cost of your treatment brings more stress on you, as you mentioned it in your message we really don’t need that.

Have you tried to reach Pzifer to get a copay card ? Not sure if you can have one when on Medicare but it worths checking it. I live in the USA but I am originally from France so I am always worried about the cost of treatment here. I know I am lucky to have a good insurance through my husband’s employer. Hopefully you will find financial assistance. Best of luck with Ibrance.

[Jhshl512 in reply to Lna21]

Yes I called Pfizer myself and was told we make too much money. So the money we have put aside for traveling will now have to pay for my Ibrance. It’s just not right. No med should cost that much!! Thank you for listening and replying

[library2019 in reply to Jhshl512]

Do you have a social worker where you get treatment? My social worker found Cancer Care Foundation that will pay part of my Chemo and there are other foundations out there that help I'm on medicare and Aetna but still have a high co pay so the foundations pays the chemo part and they paid my Ibrance when I was on it

[Jhshl512 in reply to library2019]

I do have a social worker and once again was told there is nothing they can do. So frustrating. I also have a pharmacy Liason who also said we make to much money to qualify for any help. So I can pay this copay and look out my window and watch the world go by because that’s all I can afford to do. Thank you for listening.

[library2019 in reply to Jhshl512]

Wow that's terrible I thought we made too much both are on social security but they accepted us did not ask about savings or 401k

[Jhshl512 in reply to library2019]

You’re right, they don’t ask about savings or 401k but required our tax returns. That indicates that we make about 20k over. You might think we were lawyers or doctors. Nope. I’m a disabled 62 year young secretary and my husband is a retired carpenter. Just NOT RIGHT

[viennagirl]

Hi. It is time to move to Canada. My Ibrance and Letrozole are free. I don't think we are as rich as the USA but our government really cares about our health.

It is sad news that you are going to have to pay so much for your drugs. It is just wrong to charge you that kind of money. Those drugs should be free. I wouldn't be able to take my drugs if I had to pay that amount of money.

The good news is that you have lived 8 years with mbc. It means you are a fighter. You are doing well and I think you will find a solution to this problem.

I have a relation who lived in the USA with the Aids virus. He didn't pay a penny for his anti-viral drugs. So why do you have to pay?

I think you should take your fight to the newspapers. I think you should make a big fuss over this. There is no excuse for making you pay for this life saving drug.

Not all mbc women in the USA pay for their drugs. I don't remember who they are but I remember hearing that some of our group have their drugs paid for. Maybe you will get some advice from them on this site. I sure hope so.

If you cannot get help, you might consider going to a naturopath because there might be alternative treatments that are cheap and work as well for you. But in the meantime, maybe you should go to the news paper and let them know that critically ill people are being forced to pay absurd amounts for drugs. Even if you could afford it I think it is wrong. It should be free. It just seems wrong to me to take advantage of ill people. Maybe you could send a letter or email Bernie Sanders. I like Senator Bernie Sanders. He seems to really care about Americans. He needs to know what is going on. No one should ever have to pay for life saving drugs. It is wrong.

I will keep you in my prayers. I pray to the goddess Gaia - she is mother earth. Hugs Vienna

[Jhshl512 in reply to viennagirl]

Thank you for your heartfelt reply. I did think about reaching out to our city newspaper. It’s worth a try. I also like Bernie Sanders. Thank you for that idea as well. God Bless

[Hidden]

I was in the same predicament. You can reach out to Pfizer directly for copay assistance. I paid $2800.00 copay in January, that’s with Medicare, AARP, and Rx plan. Pfizer will be helping with zero cost to me for the remaining of the year. Thank God! Give them a call. Good luck,

[Jhshl512 in reply to Hidden]

I did reach out to Pfizer and they said I didn’t qualify for any help. Just not right! Thanks for listening

[OceanBreeze3 in reply to Jhshl512]

Here is the link: pfizeroncologytogether.com/... Look it all over very carefully. If you have BCBS you can fill out for the co pay assistant card under commercial insurance. I am in the US. I have BCBS. You need to make sure Accredo has your BCBS listed first for insurance, then Pfizer co pay assistant card, then any other insurance after those 2 (even govt ones). This co-pay is NOT based on your finances and they never ask how much you make when you fill it out. You get the card as soon as you fill out the brief paperwork. Call Accredo (or who ever fills your meds) with the numbers and make sure your primary insurance is billed first then the Pfizer co-pay card. I pay nothing for my Ibrance and the cost Pfizer picks up goes to my deductible as well.

[Jhshl512 in reply to OceanBreeze3]

Thank you for your reply. Unfortunately I have Medicare, which is prime. I will once again try to reach out to Pfizer, but I’ve been rejected so many times that I’m really not hopeful🙏🏻

[OceanBreeze3 in reply to Jhshl512]

Stop calling Pfizer and you should still fill out the info for the co-pay assistant card ONLINE and call your pharmacy to have the card put in - make sure they do Medicare first then the co-pay card, then the rest of your insurances. You might be very surprised. At this point, what do you have to lose and others have said, they get it being on Medicare. Just do it! If it doesnt work out then look into the cheapest commercial insurance you can find which still might be cheaper per year than paying out all the money in a co-pay for the year. . Pfizer co- pay card will pick up $25,000 year in cost of the Ibrance. You can get a new co-pay card every time it expires which is usually 2 years.

[Tolife_18 in reply to OceanBreeze3]

My specialty pharmacy (Acreedo) took care of getting the approval. And yes, you qualify for $25K annually regarding of the income with one condition. You have to be on commercial insurance. That was the only question I was asked.

[Jhshl512 in reply to Tolife_18]

Right, but I’m on Medicare and Medicare does not negotiate prices on prescriptions. So therefore I don’t qualify. Thank you for trying to help

[Tolife_18 in reply to Jhshl512]

It’s very unfortunate. Try to search for this topic in the forum. It comes up pretty frequently. Hope you’ll find something helpful for your situation.

[Jhshl512 in reply to Tolife_18]

Than you Tolife_18!

[Pachira in reply to Jhshl512]

Trump signed an executive order September 2020 “most favored nation” which said that Medicare could refuse to pay high prices for drugs if another country with a similar gdp paid less. When I was looking at the cost of Ibrance I called Shiba (every State has one) (Statewide health insurance benefits advisor) she couldn’t help me with a better plan and said the NewYork attorney general had filed to prevent this from happening. It might be worth calling Shiba for whichever State you live in as the original poster who might have lived in Texas ended up getting Ibrance for free. Good luck!

[Jhshl512 in reply to Pachira]

Thank you Pachira. It’s worth a try. I appreciate your idea!!

[Adele_Julia in reply to OceanBreeze3]

Bingo !

[Hidden in reply to Jhshl512]

Pfizer receptionist (?) told me the same thing when I called. I went ahead and completed application and faxed it over. I was pleasantly surprised when approved.

[Jhshl512 in reply to Hidden]

Thank you. I will try

[Tolife_18]

Very sorry to hear about your financial struggle and congratulations on 8 years and going strongly! I’m not on Medicare, but from I understand there are different supplements available. Perhaps, it worth while to contact a consultant to see which one is optimal for you. Also, Phizer has different patient assistance plans. It’s quite complicated to navigate them. If you use a specialty pharmacy, they could be a great help. They helped me already.

Wish you well.

[Hidden in reply to Tolife_18]

True. Specialty pharmacies have links to multiple assistance funds, reach out to them as well.

[Jhshl512]

Thank you for your reply. I have tried reaching out to my blue cross supplement. Once again they said nothing they can do. I just don’t know where to turn.

[JeniMcC]

Hi Jhshl512,

I used to work for a Health Care Co-op in Texas. Here’s a healthcare hack you can try. We would get discounted drugs for our members by contracting with what is called a “340B vendor pharmacy”. Basically, these are pharmacies that are attached to health care facilities that serve Medicaid patients (these places are community clinics, having a designation as a “Federally Qualified Health Clinic or FQHC”—they are not just Physician’s who accept Medicaid. There’s a difference. You have to have at least one physician assigned to you at the health care facility to get this benefit, as the prescription goes through them. Drug companies, when they supply these pharmacies, must cap the cost of drugs for the patient. Here’s the data on the cost of Ibrance through this system(look at the 340B pricing category, which is capped at under $300 here): txvendordrug.com/formulary/...

Where do you live?

Many Blessings to you!

JeniMcC

P.S. this was our workaround when the drug company discounts wouldn’t work.

[Jhshl512 in reply to JeniMcC]

Thank your for your reply JeniMcC. I live in RI. Unfortunately I don’t qualify for Medicaid. Blessings to you as well

[JeniMcC in reply to Jhshl512]

Hi Jhshl512, they will also serve Medicare patients. Look up the FQHC’s with pharmacies in your state and call the pharmacist. Ask if you can get 340B pricing on drugs if you have a prescribing physician in the FQHC. Only mention later that it’s Ibrance. If you need help, send me a note. I am busy today, but the weekend will be better.

[JeniMcC]

Unfortunately, it’s the only Federally-mandated safety net we have. We did this with patients regardless of income. The prescribing physician just had to come from the FQHC. It’s definitely worth a try. -JeniMcC

[Dragonfly2]

I’m so sorry...I was in an identical situation regarding the cost of IBrance copay. You need go visit an insurance agent who can run the numbers on different policies. There are policies that have higher premiums up front but will cover the cost with reasonable copays. You may end up paying $3-400 @ month for premiums but it won’t be $2k. US health insurance at its finest. Pfizer is set to make $14B from their vaccines this year...yet they can’t revise the cost of cancer meds.

[Jhshl512 in reply to Dragonfly2]

I wholeheartedly agree with you. I will look into other Pharm policies but I can’t do that until open enrollment this year. I’m 62 and the ONLY supplement I qualify for is blue cross. Something needs to change. Thank you for your suggestions

[Adele_Julia]

Definitely get with Pfizer or have your Onc get the copay card. Pfizer doesn't discriminate based on salary so something is odd if you can't get the copay card from Pfizer or have your onc order it. Mine onc orders the iBrance for me and got the card on my behalf ! Do not be paying for that ! xoxo

[Jhshl512 in reply to Adele_Julia]

Can I ask what state you are from? I did download the application like someone suggested I do and I will apply directly to Pfizer, but now I’m curious why my onc isn’t aware of this. Is it because I have Medicare as my prime?

[Adele_Julia]

Hi there. I live in Arizona. I'm not on Medicare but my understanding is that Pfizer does not have any limitation to what insurance you're on. I also signed up for an initial consult with an iBrance mentor who works for Pfizer. Great session !

[Jhshl512 in reply to Adele_Julia]

Ok, so through speaking to everyone on this forum it sounds like my biggest problem is Medicare and my income. Try and stay away from Medicare as long as you can. I was also told that drug companies don’t negotiate with h Medicare. Good luck and God Bless

[Dragonfly2]

Hello JHSH...somehow I missed your posting and I’m so sorry about your costly situation. It’s a frightening and terribly unfair situation. I hope you can see an insurance agent to research if there is a plan that can cover the cost better. There are plans that have expensive premiums but do a better job on the copays. With Pfizer making nearly 2b$ this year on the covid vaccine, you would think they’d have the empathy to make this drug more affordable. Ugh. I’m so sorry.

[Jhshl512 in reply to Dragonfly2]

Yes I totally agree about Pfizer. I actually read on the internet that Pfizer considers Ibrance a cash cow for their company. So sad and disappointing. I will continue to look into insurance options. Thank you for your reply.