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Discussion about insurance, treatment costs, and patient assistance programs

Medicare coverage of Revlimid

by stephanielimb on Tue Jan 10, 2012 6:30 pm

My mom is a new Medicare patient and has been prescribed Revlimid post-stem cell transplant as a maintenance therapy. The cost: $3000 for 1 month. This is utterly unbelievable to me. We are working with Celgene to get financial aid but I'm wondering what others' experiences have been.

How/why is this kind of copay allowed in the Medicare program?

Thanks all,

Stephanie

stephanielimb

Re: Medicare coverage of Revlimid

by Dr. Peter Voorhees on Wed Jan 11, 2012 1:30 am

Dear Stephanie,

This is a huge and unfortunately common problem. Hopefully there will be reforms to how Medicare handles expensive oral chemotherapy drugs in the not-too-distant future. In the meantime, your mother's oncologist ought to have someone who deals with these issues on a regular basis and is knowledgeable about where to go for financial help. Celgene or a foundation may be able to provide co-pay assistance depending on the circumstances.

Good luck and let us know how things go!

Pete V.
Dr. Peter Voorhees
University of North Carolina at Chapel Hill

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Peter Voorhees
Name: Peter Voorhees, M.D.
Beacon Medical Advisor

Re: Medicare coverage of Revlimid

by stephanielimb on Thu Jan 12, 2012 4:00 pm

Thank you Dr. V! If docs are advocating/lobbying for Medicare change on the oral chemotherapy drug issue, I hope you'll tap into families and patients for support. I know that we were totally shocked and outraged. Celgene is being helpful; just seems silly to take "charity" when she has a perfectly good insurance policy....

Stephanie

stephanielimb

Re: Medicare coverage of Revlimid

by BeverlyJean on Mon Feb 06, 2012 12:32 pm

Contact the Chronic Disease Fund on line for an application or call them for info. My partners 2800 dollar co-pay ended up being 10.00. Also try the International Myeloma Foundation or the Multiple Myeloma Research Foundation. All of the above, along with the drug manufacturer can assist with co-pays after qualifying. On another note, various states are trying to get Medicare to pay for oral chemo therapy under Part B Medicare the way they do for Intravenous chemotherapy. Sixteen or Seventeen states have already passed legislation to do this and others are in the process so keep your eye out for that legislation.

BeverlyJean

Re: Medicare coverage of Revlimid

by reframingham2 on Mon Feb 20, 2012 12:09 pm

basic question
What about us who have a decent retirement income and do not qualify for assistance?
Are we supposed to pay our savings to allow celgene to make an obscene profit?

reframingham2

Re: Medicare coverage of Revlimid

by Ron Harvot on Thu Feb 23, 2012 3:57 pm

This is an indictment of our medical RX system. As an employee my co-pay for 10mg 21 day cycle of Revlimid is $14. Until the medicare perscription drug benefit co-pay is equalized to employer provided health care programs, the best adivice is we can never retire. If we can work we will have to continue to work until we are physically unable to. Once retired unless you are independently wealthy the prospects are not good financially for any of us. We need companies like Celegne to continue finding new drugs to combat this disease. However, as patients the cost of drugs like Revlimid are really obscene and financially devistating to people on fixed retirement incomes with medicare. Something has to be done but the political will is not there. The mantra in Washington is to reduce costs and the deficit, thus any talk of subsidizing chronic care medicare patients will be met with defening silence. It is bad enough we have to fight for our physical lives. We shouldn't also have to worry about our financial lives as well. This is a cruel disease.

Ron

Ron Harvot

Re: Medicare coverage of Revlimid

by georgechaisson@comcast.net on Mon Mar 05, 2012 5:53 pm

to: reframingham2

Also from Framingham, Diagnosted with multiple myeloma on 16 Dec 2011

And yes Revlimid cost have me frightened.
Just finishing chemo Cycle one - expect 4 to 6 cycles; w/ Stem Cell Transplant to follow.

I contacted Celgene however, no help.
I did not need or sign up fpr Medicare Part D for 2012; so I am running the finacial gauntlet alone.

georgechaisson@comcast.net

Re: Medicare coverage of Revlimid

by Redrose69 on Tue Apr 24, 2012 2:07 pm

reframingham2 wrote:
> basic question
> What about us who have a decent retirement income and do not qualify for
> assistance?
> Are we supposed to pay our savings to allow celgene to make an obscene
> profit?




I am in the same boat. No one seems to be trying to confront Celgene about the cost. Guess MMF and others think we should be thankful that we can spend all out hard earned money on multiple myeloma and survive. My state will never do anything to help the situation.

Redrose69

Re: Medicare coverage of Revlimid

by nelsonthomascl on Mon May 07, 2012 3:45 pm

We got help through the Chronic Diseas Foundation out of Texas . With our private insurance and medicare and because by husband needs the drug, we got it through the fun with our financial background. Both of us on Social Security and in our 70's. Their number is 877-968-7233. We got it with the help of Kaiser. We pay 10.00 a month and saw the price was actually (without insurance) $8432.00. We almost fainted.

nelsonthomascl

Re: Medicare coverage of Revlimid

by artist1926 on Tue May 15, 2012 8:53 am

BeverlyJean wrote:
> Contact the Chronic Disease Fund on line for an application or call them
> for info. My partners 2800 dollar co-pay ended up being 10.00. Also try the
> International Myeloma Foundation or the Multiple Myeloma Research
> Foundation. All of the above, along with the drug manufacturer can assist
> with co-pays after qualifying. On another note, various states are trying
> to get Medicare to pay for oral chemo therapy under Part B Medicare the way
> they do for Intravenous chemotherapy. Sixteen or Seventeen states have
> already passed legislation to do this and others are in the process so keep
> your eye out for that legislation.

Can you tell me which states have passed this legislation and where you saw this info. Thanks reply to artist1926@earthlink.net

artist1926

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