Ibrance (Palbociclib)
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I’m very well aware that 100% of plans does not mean 100% coverage. It’s the fine print on the Ibrance website that frosts my butt because it’s the fine print that will put you in the poor house.
Right now I have excellent coverage through my husband’s employer (he retired at 54 but can continue to carry me). I pay a $20 co-pay for Ibrance. For that I’m grateful. Once I go on Medicare, I will continue to pay for his insurance as my supplement. Am I correct in thinking that there is no way to pay for a prescription drug supplement (similar to medical coverage)? I’m just learning this stuff so your knowledge and experience is much appreciated.Our income is high enough that I doubt I’d qualify for financial assistance. I’m just trying to pay for comprehensive insurance that will not leave me with a shocking drug co-pay each month.
I’m grateful to not be on IV chemo but if I was on chemo, it would be covered by major medical and be so much easier.
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RK2020,
I don't know the answer to your question about the prescription drug supplement. If you get your drugs now through your husband's medical plan, I assume that would continue and you would get a notice from them of "creditable coverage" so you wouldn't need a prescription plan. So you might be okay. You can also do an inquiry with them to ask what the story is -- better to know now.
My hubby also retired at 54, but I just retired at 68. However, I was covered under his medical insurance for most of our married lives. His plan, however, kicked us out when we each turned 65. They had a "retiree medical plan" but it wasn't going to really help us with prescriptions, so we went the traditional route.
And I agree about the chemo -- but Medicare plus my supplemental Medicare insurance picks up the entire cost of my faslodex shots (which aren't so cheap, either) because they are administered in a doctor's office or in a hospital setting -- so they fall under Part B.
Fun stuff to figure out. No matter how well you plan....
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BevJen - I told my husband at lunch today that he needs to call about his insurance NOW so that I can relax. Lol. I’m on cycle 9 of Ibrance and my blood numbers FINALLY turned the corner (an ANC of 1690 on day 14 and 1490 after 7 days rest)! I haven’t seen these kinds of numbers since I joined this circus. If this becomes my new norm I just may be on this drug for awhile and need to figure out how to pay for it. I guess that’s a good problem to have. Frustrating but good. MBC is the gift that keeps on giving. 🤪
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RK2020, when you go on Medicare, you can buy a supplement and part D drug insurance. But it seems like your husband's insurance covers drugs? (Nice copay, BTW.) If you use that as a supplement, will it still cover drugs? I'm pretty sure you can't have two different insurances covering drugs and if you do, they want a piece of both. I get a letter every year asking me if I have two insurance policies covering my drugs because they see the grant and my Humana part D policy. I always have to call them and explain that the grant is not insurance. It always works out but just one more hoop to jump through. I'm sorry if I misspoke. I figured all this stuff out five years ago when it all was new. A lot has changed since then. It is hard to keep up with it all.
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Price differences for RX is increadible/ludicrous. And differences in brand vs generic. I was able to keep my private after retiring and am trying to understand Medicare , Medicare combined with private - 2 years before I have to make that decision My oncologist submited Rx to pharmacy she said they had a grant with. First 2 boxes, free. Then Insurance contacted me and told me I must use the Specialty Pharmacy in the Insurance Plan, and my cost went to $50/month. It is also discouraging, because it seemed as if the original pharmacy was more knowledgeable. I have not been notified of any expected price change for next year, but I better ask.
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my insurance has also changed plans for prescription medications effective Jan 1, 2021, it also included changing pharmacies to selected pharmacies. I received a notice letter a couple of weeks ago but tossed it out, after seeing your posts got back and started to understand what is going on... no one in insurance company knows what will happen, I was told that I have to wait until Jan 1 then call to the new plan phone number see what they will tell you! I actually called that number it is like: for this option press 1 or 2 then back to main menu.... so annoying... Hhh I thought I only deal with mbc, I don’t know if I should be more worry about my MCV and MCH at the moment or my medications.
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Hi Ladies, It was interesting reading about your drug costs. Don't go on A/A. Afinitor 5mg tablets (that' half the dose ONC wants me on is,,,,$25,950.79 for just 28 pills. Cant find the info for the other med but (by memory, and we all know how good memory info is) it's $17,000 for thirty. No wonder insurance is so high. I don't think I'll be on it much longer haven't scanned yet but breast tumor is growing. I did better on Zeloda no shrinkage but no progression either
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Snooky,
Wow, that's an eye popping number on both drugs. Are either of them infused, or are they both pills?
Something has to be done in this country regarding drug costs. What good is it to have all of these great drugs if people cannot afford them?
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BevJen, I know it's crazy and nope not IV -just pills. One of them is so small, a bit bigger than a stick pin top, for that kind of money.
It's not all the drug makers either it's pharmacy mark-up.
Oh the heck of it is, these are generics!!
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it's criminal how much the insurance coverage varies and how much these necessary drugs cost . So far (in 2020) my husband's medical coverage has been great...first Ibrance Nov 2019 was n/c at the cancer center . Had to work with Premera and cancer ctr to order ever since - need to use Accredo online pharmacy . Cost is $20,000 a month with no coverage if I don't use Accredo . My copay is $2000 / month but premera enrolled me in a manufacturers program to cover the co-pay. It was not income dependent. I am fortunate to have no costs to Ibrance right now . We are not changing our benefits for 2021 and I think it should be the same. My husband has been pursued by a competing firm and honestly would like to change companies but we feel like he can't risk changing due to my neededmedical coverage .
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Hello, I understand that someone may be on IBRANCE for the second timje. I have difficulty with my vision so hard for me to read through the thread. I just had progression on Xeloda and am told my next step is IV chemo which I'm trying to avoid as long as possible. Has anyone repeated IBRANCE havinb eeen on it before?
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Dorimak... that depends on which country you are in. In the UK it is not possible to have Ibrance, or any other CDK4/6 inhibitor as a second line treatment. It appears that this is possible in the USA though. I am in the same boat as you, progression after first line and now on Faslodex only.
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Hello....new here!
I have a question about the cycles you are referring to. Is a month considered a cycle? I haven't started yet, still waiting to hear back that my insurance is okay with it. I'm just curious as to the verbiage being used. My MO doesn't really explain the medication as a round of chemo, but is Ibrance like " chemo light " ?
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Tanga, Ibrance is considered a chemo drug by insurance companies, but administered orally. Don’t worry it’s pretty tolerable and also don’t worry if they drop your dosage down the line.... it’s effective to 75mg per cycle depending on your tolerance.
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Tangandchris,
Also, a "cycle" is basically 28 days -- 21 days on the pills, 7 days off.
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Best wishes to all of you dealing with this disease
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Dorimak yes there have been some who did another treatment and then came back. Sometimes they changed to letrozole or faslodex with the ibrance. I think it depends on if there was a mutation or what the progression was. I hope one of them chimes in soon.
December 11 and you too.
Tanya
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Hi, I'm one of those who left Ibrance and came back.
I switched to Lynparza after progression, then came back to Ibrance, switching the Arimidex (AI) to Faslodex. This was recommended after the Guardiant360 blood test. I chose to take 75mg and had regression on subsequent scans. In fact, I had considerably less discomfort in the sacrum after just a couple of months on this plan.
I'm a believer that we can trick those cancer cells into thinking this is a whole brand new drug!
Love and hugs to all of you from PatGMc
Have a wonderful week!
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RRabbit- Any news yet on your scan from last week? And another due this week?
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PatGMc thanks for sharing your experience, it really helps reduce my stress, tangandchrist question would be mine at some point, and I like your comment “I'm a believer that we can trick those cancer cells into thinking this is a whole brand new drug!“ 👍🏻👍🏻
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Good morning!
Definitely check Medicare RX plans before December 5. My plan from last year dropped Ibrance completely. (United Healthcare). I found a different plan and will need to order it through one of the grocery store pharmacies or a local delivery pharmacy. Neither CVS nor Walgreens available without an extra $100 per month premium.
The paperwork and frustration will get us before the cancer🙄
Hoping for some good changes in the new administration
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Pat, great to hear from you... how’re you doing on the Faslodex?
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I-beat-it, I credit Cure-ious with making the case that revisiting Ibrance is a viable option!
Karen, I'm so thankful that my aches and pains from the AI are gone and Faslodex doesn't seem to cause those......you know, the ones that feel like you've pulled a tendon (when you know you didn't because your rear end has been Velcro'd to the couch for years)! Ibrance fatigue, nausea and indigestion remain with me but I sit here and make art and thank God I'm alive! The fact that I can throw up without much notice makes me socially unacceptable but I have a sweet and funny husband, daughter and granddaughter who make up for the rest of the world.
The Faslodex shots don't bother me since I follow the suggestions learned from the wise women of this thread. I get them lying down in a recliner, walk a bit once they're done, use a roller on my hips for days and keep a heating pad on all the time. No problems!
I haven't lost faith that a day is coming when we will be cured by immunotherapy and will have to hire trainers to get our muscles working again.
Here's to that!
Love from PatGMc
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Pat...from your lips to God's ears!!!
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Jack5ie - I agree!
Pat - so good to hear from you and it's great that you are doing well, shots not bothering you etc.
Candy - you are so great at keeping up on everyone's scans, I appreciate that so much!
RRabbit - hope your scans and appt are good!
Tangandchris - welcome to the Ibrance group. You will find great support here! This month is my 12 month "metaversary" for lack of a better term, one year on Ibrance/Faslodex.
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SABCS Abstracts are online:https://www.sabcs.org/Portals/SABCS2016/2020%20SAB...
It's a slow slog reading through them, so many are not relevant to metastatic cancers. They do report the 5 day on, two day off schedule for Ibrance was just as effective as the 21 day on, 7 day off, schedule and was better tolerated in terms of lowered white cell counts.
A phase 3 trial tested whether adding an HDAC inhibitor (entinostat) to exemestane could restore estrogen-dependence to cancers that had progressed on endocrine therapy. People in the trial had been treated with an average of 2 endocrine therapies plus one chemo in the metastatic setting. The PFS for the entinostat-exemestane combo was 3.3 months, compared to 3.1 months for exemestane alone- ouch!!!
Another phase 3 trial was unable to replicate the results they reported in phase 2 LOTUS trial, and overall showed no benefit to adding the mTOR inhibitor ipatisertib (a drug like Piqray) to paclitaxel as firstline treatment for PI3KCA mutant mTNBC....
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Thanks Cure-ious. I will read thru it later. I am on the 5 day on, 2 day off schedule. My ANC is still low at 900 for the monthly/beginning of next cycle check. But back to my baseline and better than 500 that I was at with the normal scheduling.
Hopefully MO's will be willing to use this scheduling for anyone that is struggling with their ANC numbers. Now that the results are in and being presented at SABCS.
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Page 67 of the link for those that want to read about the alternate scheduling of Ibrance.
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Phase 1b trial of Ibrance, Faslodex plus a pan-FGFR tyrosine kinase inhibitor (TKI) erdafitinib in FGFR-amplified/ ER-positive, Her2-negative MBC
Only 18 evaluable patients in the trial so far. median PFS was 3 months and clinical benefit rate at 6 months was 28%. "However, a higher PFS (6 months) was seen in 6/8 patients with high levels of FGFR1 amplification (FISH FGFR1:CEP8 ratio >5; gene copy number >10) and in both patients with FGFR3 amplification.Conclusion: To our knowledge, this is the first time an FGFR inhibitor has been tested in combination with ET and CDK4/6i in patients with MBC harboring FGFR alterations. Erdafitinib-related side effects appeared to be on target, leading to treatment discontinuation in several patients despite optimal medical treatment. Clinical activity was seen in heavily pre-treated patients with molecular evidence of high FGFR amplification despite 100% prior exposure to endocrine therapy and CDK4/6i. "
Looks like they get a lot of side effects with this drug...
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5/2 it’s official then, good news to stawith ibrance a little more. Cure-ious and Candy thanks for sharing the article and your experience.
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