Price of chemo meds pills 💊

[Hotlantaphatz]

WTF! $1900 copay for 21 day round. Tired of calling around for grants, etc. I am very angry and disgusted!

[LDR1]

what? That’s terrible which meds? So far I’ve been able to get CoPay Assistance Program coupons from the drug manufacturers that covered the crazy copay amounts … hoping something like that will be available to you 🙏🙏💜

[Hotlantaphatz in reply to LDR1]

Xeloda

[13plus]

It's insane isn't it?! But as LDR1 shared, so far I've always had full assistance thru the manufacturer's assistance programs. Try talking to your doctor's office. They are usually the ones that make that connection for you. Just make sure to tell them that your insurance doesn't cover that drug. Though now I as I write this, I recall there might be issues with people who are on medicare? Is that the problem here?

[HelenWi in reply to 13plus]

My Dr office set up Ibrance for me with Pfizer’s assistance program. Medicare was not an issue. I have part D but the copay is ridiculous, even after you reach “catastrophic” level.

[Hotlantaphatz in reply to 13plus]

my insurance copay is $1,900. The manufacturer will evaluate my request once I have been turned down by other agencies!!!

[13plus in reply to Hotlantaphatz]

I know it's very scary. I remember well holding my breath when I was first put on these drugs a few years back and wondering if I was really going to get assistance. I was so very grateful when it came through! Then I went through it again changing calendar years, then again changing meds to a different manufacturer. I hope like hell my good fortune with this assistance continues.

As a matter of interest I became aware that it seems it is still somehow tied to a deal the manufacturer's does with the insurance, even though I don't pay anything, but it's all done on their side of things so we are not privy to the deal. It's such a dirty stinking business! I detest the health system in this country, having also lived and got to use at least a bit the health systems in Australia, UK, and Germany (the best of them!). The only thing that has kept me going though really is when Obama brought in the Affordable Care Act. Without it I would've been doomed. It's far from perfect but it has certainly helped me anyway. Now they need to keep chipping away the rest of the messed up system!

[Best521 in reply to 13plus]

My sister in law is German. It is amazing how well cared for she and her family are. Maybe one day we will be able to focus solely on our health rather than worry about medical bills here in the US. But for me not this year as I get ready to pay $2,500.00 for medical bills that went to the deductible. Never get diagnosed with cancer at the end of the year or you end up covering two deductibles as I did in 2021 and 2022 when I was diagnosed in November of 2021. I am blessed to have had the money to pay but many are not.

[13plus in reply to Hotlantaphatz]

I got sidetracked, lol. I meant to say, even though it is scary, try to keep from stressing about it. Most oncology offices at hospitals are equipped with the resources to know how to go about applying on your behalf. I'm sure it will all work out in your favor in the end. Hugs as you wait!

[sevoia in reply to 13plus]

I am on medicare, but do not have part D as medically I did not have any problems and did not take any medicines until I got cancer at age 72. Then I was put on Faslodex and Medicare paid for that, so I assumed Medicare paid for cancer medicines. Then my cancer metastasized and I was put on Ibrance. What a shock. The cost would have been catastrophic for me. Luckily my Doctor got me on the. Pfizer's assistance program. However, I have to get requalified every year and at present, I am waiting to hear if they will assist me this year.

[13plus in reply to sevoia]

That was very fortunate that you were able to get on the assistance program already. Hope the same continues for you!

The whole system is so messed up

[sevoia in reply to 13plus]

Yes I was lucky and I hope they will continue to help me. I agree the whole system is a mess. I don't know what the rational is that Medicare pays for injectable medicines but not for pills.

[13plus in reply to sevoia]

I think mostly the price is the issue, rather than injectable vs pills. Faslodex is basically a hormone blocker but iBrance is in a whole other league as a specific type of cancer drug.

[sevoia in reply to 13plus]

True Faslodex is a hormone blocker , but so is Letrozole and I did not have to pay for the Faslodex which was quite expensive, but I do have to pay for the Letrozole, which is quite cheap.

[13plus in reply to sevoia]

crazy! I guess it all boils down to “deal” or “no deal” then between the individual pharma companies and the government!

[Photo-Bug]

See if you can get some help from a nurse navigator or the pharmacy department of your cancer center. They usually know who to contact or who you can contact to get financial assistance. If that doesn't work, tell you doc that you need a less expensive medicine or have the doc lead you to someone who can help. It is a jungle out there if you don't know the ropes. Prayers for you and a successful outcome.

Sharon

[Southside25]

My Specialty Pharmacy, who provided my Ibrance ($13,000 a month), did all the legwork in obtaining grant money to pay what my Plan D didn't pay. I was able to get private grants for a couple of years. When grants ran out, I got assistance from the manufacturer. Your doctor's office, or more likely, your pharmacist should be able to help you find assistance.

[Silver126 in reply to Southside25]

it’s unbelievable how higher prices are in the States! In Italy this treatment is covered by the NSH and prices are lower. I was on Ribociclib and the price was €7.900 for a complete 600mg cycle. More or less 7.900$. Ibrance is cheeper than Ribociclib (Kisqali)

[Crazycocker]

I can’t believe how much you’re having to pay! We think our NHS system in the uk is broken but but after reading your post I realise it isn’t, well maybe some parts of it are? But I’ve been on palbociclib for very nearly 3 years and it’s all covered by the NHS. I’m feeling incredibly grateful right now. I really hope and pray you manage to get the help you need to financially support you and you can afford the medication you need. X

[Best521]

Our system of healthcare coverage in the USA is Barbaric. The number one reason for personal bankruptcy in the US is medical bills and the number one reason for those medical bills is Cancer. The weak and suffering left to scramble for treatments at the mercy of powerful moneyed interests. Enough is enough.

[Urca in reply to Best521]

It's unbeliveable! I'm Italian and here all medical care is free for everyone, even for those people who have never paid taxes

[Hotlantaphatz in reply to Best521]

I agree 100% .

[Best521]

Financial Toxicity is the other Toxicity here in the US. Doctors refer to stopping treatment due to financial toxicity. People are routinely forced to go off meds because they can’t afford them due to inadequate health insurance, high deductibles and copays, donut holes, loss of employer paid insurance due to job loss and more. One friend had to forego an anti nausea medication because she had not met her deductible yet and couldn’t afford to pay out of pocket that month. It is not only cancer patients, a friend had to stop one of her diabetes drugs because she fell into the Medicare Donut Hole and couldn’t afford to spend her way out. People are left to beg on social media sites such as Go Fund Me for money to pay for medical care. It is truly horrifying how we treat our most vulnerable people.

[Hotlantaphatz in reply to Best521]

yes I feel like I am begging and in the middle of a gunfight between docs and pharmacy. Not good!!!!!!

[NShaft]

The PAN foundation offers Grants for co pay help. Most drug companies also offer co pay assistance. Your onc office should be familiar with all of that and can help you. There may also be a social worker affiliated with your onc office who can assist. There are resources but it may require some leg work on your part. It is frustrating to have to add this to dealing with MBC .

[Hotlantaphatz in reply to NShaft]

yes I called my onc, until I get approval from the manufacturer grant they were able to provide me with a prescription .

[mariootsi]

It's a sin what they charge for our meds!

[PlutosNose]

Hello to Atlanta from the North GA mountains!

The Prescription Drug Provisions of the Inflation Reduction Act of 2022 makes some MAJOR changes in part “D” coverage in the upcoming years... only a few this year but mainly in 2024 (elimination of the 5% coinsurance when you move into “catastrophic coverage”) and 2025 ($2,000 CAP on max out-of-pocket charges for drugs!!)

This might make it worth discussing with an insurance agent what it would take to add a part “D” plan to your coverage in the next cycle. I have a “D” plan that has very low monthly charges… I have never used it (a get Letrozole from Health Warehouse which is much cheaper than going through the plan) but I keep it so that it’s there when I need an very expensive cancer drug that I don’t qualify for assistance on.

Here is a chart that steps through changes year by year:

brooksfinancialsc.com/2022/...

and an article specifically about the changes in 2023:

seniorsleague.org/how-will-...

If you don’t like clicking links just search for:

implementation timeline of the prescription drug provisions in the senate reconciliation proposal

If anyone out there has more or better information on these provisions please let us all know!!

-Wishing you all a peaceful and happy day

[Hotlantaphatz in reply to PlutosNose]

thank you so very much for this information!!!

[Sharon0122]

Yes I was shocked at the price too, my co at was $2900!!’ My doctor has set me up with Pfizer oncology and I get it for free. You have to be re- evaluated each year in January. They sent two months wort in December. Now I’m waiting for the answer. I also have just been put on eliquis and that is another very expensive drug. $850 a month, for the rest of my life. Call your doctor the will do all the paperwork . Best to you!

[Hotlantaphatz in reply to Sharon0122]

will do

[NPmary]

That's just ridiculous!

[Adamskd1]

Hi there. I work for SHARE Cancer Support and I found this resource for you. I hope this helps. genentech-access.com/patien...

For more support through our helpline or support groups, go to: sharecancersupport.org/cale...

Or call our helpline at 1-844-275-7427

[RLN-overcomer]

Sister/Warrior, and Advocate I am sooo sorry you have to fight for medication that could increase your longevity, and or save your life. My heart goes out to you, and I feel your frustration. I do hope pray you can have someone, either a loved one or a HospitalAdvocate/Social Worker that can intercede on your behalf.Amen XoXoXo

[ClarenceO]

Yes, it is extremely stressful to deal with drug assistance. My co pay for Ibrance under Medicare part D was going to be close to $3k/month vs zero under my private health insurance.

The assistance Dpt at my hospital was turned down for foundation assistance as I ran out out of Ibrance pills. I had started working on this 2 months prior and was now out of life sustaining meds! (Medicare policy prohibits application for financial assistance until AFTER a person commits to starting on Medicare so it is a significant cost risk.)

I took matters into my own hands and applied directly to Pfizer for help. They were fantastic and despite my HC Physician’s Assistant not submitting the diagnostic form to Pfizer after asking several times, my oncologist responded immediately and I was approved for Ibrance for free.

I called Pfizer again to request renewal in 2023 and they granted it in one phone call. The young lady I spoke with in the Pfizer Together program was amazing. It took only 15 minutes.

Sometimes it is easier to do things yourself rather than wading through bureaucratic systems here in the U.S.. We need national healthcare!

Suzanne

[Hotlantaphatz in reply to ClarenceO]

all I can say is Wow! I was denied on two programs. My onc applied at manufacturer. Waiting. I wrote my congressman. Got a quick reply and waiting on what they find out about my Medicare plan B. I hate this game.

[Buster2020 in reply to Hotlantaphatz]

Did you try the drug company directly. It took two months but I contacted Novartis for the Kisquali and received it. I hope you found a solution.

[Buster2020 in reply to Hotlantaphatz]

My Onc was unsuccessful but doing it directly seemed to work.

[Buster2020 in reply to ClarenceO]

I applied to Novartis direct for the Kisquali and they have been wonderful. I ended up doing it on my own as well. Thank you. I’m glad yours worked out for you too.

[dnamscg]

Ask the pharmacy if they have grants. I pay 0 for Ibrance and Faslodex. Mine is thru the specialty pharmacy. They even did the paperwork.

[Buster2020 in reply to dnamscg]

There were no grants available but I contacted Novartis directly and I am receiving the Kisquali through them.