Posted 8/15/2013 1:58 PM (GMT -7)
To zufus ........
It seems that the pricing is all over the place. I was placed on Zytiga in early 2012 - before going on Taxotere. I am on social security, and I do have Blue Cross - Plan F ... as well as, Plan D drug coverage with a different carrier.
When it was first prescribed, the cost was given to me at $2500. for the first month - using the Plan D drug coverage. That was considered to be the co-pay. Social Security and Blue Cross supplemental insurance were useless for this drug. They did later pay for 100% of the taxotere - because it was administered by an IV ... but they did notpay for any oral chemo.
Being Plan D, there was a "donut-hole" for coverage at around $3000. out-of-pocket last year - and a second plateau (forgot the name) at around $4500. out-of pocket. So, as a result, the first month I paid $2500. for the Zytiga ... the second month less than $1000. ... and subsequent months just under $300. per month. Note - other medications were being taken at the same time driving up the monthly costs quicker than Zytiga alone. My medication costs totaled just over $30,000. for 2012 ... my costs out-of-pocket were $6000.+ mostly because of the Plan D cost caps beyond a certain dollar amount.
Insurance coverage - and social security/supplemental coverages can vary between the two considerably.
Food for thought .................... when it came time for me to go onto Xtandi, and I heard the retail was $10,000. per month ... and thru insurance Plan D would be $2850. for at least the first month - not sure how much thereafter, I simply told my Onco ...... can't afford it!!!!!!!!
My Onco's office went to bat for me directly with the manufacturer first ... so that $600.+ out-of-pocket would be my cost for this calendar year. Now, my Onco's office found a possible agency with a benefit that could go beyond into next year for some assistance.
It shouldn't have to be this way ..... but it is!
All I can say is ....... RESEARCH, RESEARCH RESEARCH!
Best wishes ....... Rob
Initial Dx of PCa in 2003/2004
Radiation (5x5wks) & Brachytherapy (96 seeds) in 2004
Low PSA for 6-years
Casodex first - then Lupron from mid-2011 to current
Zytiga from January 2012 (5-months) - PSA increase
Prednisone from early 2012 & Xgeva from mid 2012
Taxotere from August 2012 (30-weeks) - PSA from 54+ to 12+
No chemo (8-weeks) - PSA from 12+ to over 23
Xtandi start - late June 2013 ......