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Topic: Vaginal estrogen cream- cost enormously high . Are you mad ?

Forum: "Middle Age" 40-60(ish) Years Old With Breast Cancer —

Meet others in this age-range who share similar life issues.

Posted on: Jul 12, 2019 08:16PM - edited Jul 12, 2019 08:17PM by hope2learn

hope2learn wrote:

concern for breast cancer survivors and menopausal women

Many of us with breast cancer , as well normal menopausal women have problems with vaginal dryness ( ergo also sex) and possible other pelvic floor issues .

As all of us know, this is the result of the estrogen withdrawal either brought on by aromatase inhibitors or menopause.

  • My question is why in the world are the vaginal estradiol creams costing a fortune?

I think Estrace cost roughly $186, the generic versionof estradiol from Mylan costs about $109

Even the compounded versions of the cream are going up and up.

  • Has anybody else gotten mad about this. I am.

This is a particular crucial subject matter for all breast cancer patients who suppress estrogen with Aromatase inhibitors. And it it not just about vaginal dryness and a healthy sex life . If you do not use the estrogen regularly, you can end up with some kind bladder dysfunction. So, you really do not want to skimp on that estrogen cream and use the amount prescribed.

I personal , in order to live a somewhat normal life, I spent a fortune ( for me it is ) per month out of pocket for vaginal moisturizers and vaginal estrogen cream . My drug plan does not cover it.

It is even more maddening as the amount of the drug "estradiol" per gram in that cream is absolutely minimal ( 10 micro-gram / gram).

But what can we do ? That is why all of us who need it pay it.

  • Who has a good suggestions what we could do ? A different" me too moment", but it still is .

Here is Dr. Kirtly Parker Jones from the University of Utah talking about this matter

https://healthcare.utah.edu/the-scope/shows.php?shows=0_4o5k3awe

To quote her :

"Now, if I wanted to take estradiol, my natural hormone, by pill for hot flashes, I could go to Walmart and get a 90-day supply for $10. If I wanted to use the same hormone vaginally, prepared to be absorbed by the vagina and this isn't rocket science, drug technology, it will cost $520 depending on how the estradiol is delivered. Now, $520 is the upper end, $300 is the lower end.

So what is the reason that the pharmaceutical industry puts such high prices on vaginal estradiol? It's because they can. "

Dx 8/23/2011, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jul 12, 2019 10:41PM marijen wrote:

hmm that’s a very interesting question. I wonder if drugs for men are cheaper than drugs for women, just like clothing. Have you tried Goodrx? Sometimes you can get a drug cheaper with a coupon rather than going through insurance.

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Jul 12, 2019 11:00PM coraleliz wrote:

And I thought my $60 copay on Estrace was too high. I used half the amount prescribed & every other day instead of every day. I didn't follow the link, it will make my blood boil for sure!

Dx 2/28/2011, IDC, Right, 1cm, Stage IA, Grade 1, 0/5 nodes, ER+/PR+, HER2- Dx 3/15/2011, IDC, Left, 1cm, Stage IIA, Grade 1, 2/4 nodes, ER+/PR+, HER2- Surgery 4/15/2011 Lymph node removal: Left, Right, Sentinel; Mastectomy: Left, Right
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Jul 13, 2019 05:27AM gb2115 wrote:

It's not just vaginal cream, so many meds are unaffordable. I see it all the time, Medicare claiming something is "covered" at a tier 5, but the OOP cost is over $1000 a month. Ridiculous. Don't waste our time saying our patients meds are "covered."

I don't know what to tell you, since it's not covered by your plan maybe check the brand to see if they have a coupon for it being uncovered? Drug companies do that sometimes.

Dx IDC in October 2016, stage 2A, 1.2 cm ER/PR+ Her2-, Grade 2, 1/3 nodes. Mammaprint low risk luminal A, Lumpectomy + radiation + tamoxifen. Age 38 at diagnosis.
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Jul 13, 2019 08:07AM santabarbarian wrote:

Wow, mine is covered - $10 copay - so i had no idea of the sticker price. Ridiculous.

pCR after neoadjuvant chemo w/ integrative practices Dx 7/13/2018, IDC, Left, 3cm, Stage IIB, Grade 3, ER-/PR-, HER2- (FISH) Chemotherapy 8/12/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 12/27/2018 Lumpectomy: Left Radiation Therapy 2/11/2019 Whole-breast: Breast, Lymph nodes
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Jul 13, 2019 08:33AM letsgogolf wrote:

I was using Estrace when I was diagnosed with breast cancer and was told in no uncertain terms that I should never again use it. I noticed that several of you are ER+, PR+. Is your oncologist aware that you are using this?

Oncotype DX = 3. IDC with Lobular Features. Sentinel Node had Micrometastases - Estrogen 100%, Progesterone 99.89%, Ki67= 3.3% Dx 2/14/2017, IDC, Left, 1cm, Stage IB, Grade 1, 0/8 nodes, ER+/PR+, HER2- Surgery 2/27/2017 Lumpectomy: Left Radiation Therapy 4/6/2017 Whole-breast: Lymph nodes Hormonal Therapy 6/1/2017 Arimidex (anastrozole) Targeted Therapy
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Jul 13, 2019 11:16AM Beesie wrote:

Letsgogolf, I was wondering the same thing. I remember talking to both my MO and my gynecologist, and both were very clear that these products were off limits because my breast cancer was highly ER+.

This is interesting, particularly the reference to women to take AIs: https://www.acog.org/Clinical-Guidance-and-Publica...


“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Jul 13, 2019 11:38AM letsgogolf wrote:

Beesie, That is exactly what I was told. In fact, I had issues with dryness prior to my breast cancer, liked Estrace and argued at length wanting to continue using it. Two doctors from my team talked to me, pretty much telling me that it carried too much risk and could possibly undo some of the effects of Arimidex. I remember researching myself pretty extensively at the time which was over 2 years ago and came to the conclusion that they were correct. Even the packaging inside the Estrace warns about increasing the risk of breast cancer. I guess it's up to each of us to do our own research and figure out if we are willing to take the chance.

Oncotype DX = 3. IDC with Lobular Features. Sentinel Node had Micrometastases - Estrogen 100%, Progesterone 99.89%, Ki67= 3.3% Dx 2/14/2017, IDC, Left, 1cm, Stage IB, Grade 1, 0/8 nodes, ER+/PR+, HER2- Surgery 2/27/2017 Lumpectomy: Left Radiation Therapy 4/6/2017 Whole-breast: Lymph nodes Hormonal Therapy 6/1/2017 Arimidex (anastrozole) Targeted Therapy
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Aug 12, 2019 01:12AM macb04 wrote:

I assume you have tried Vagifem or it's Generic, but just prefer the Estradiol Creams.

Here is the Good Rx price comparison here in Seattle:


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Aug 12, 2019 01:34AM WC3 wrote:

marijen:

Testosterone gel is about $250 to $700 for a 30 day supply for a man with low testosterone. However the maker of Androgel has a voucher program for men only that reduces it to $20 or something like that.

Dx 2018, IDC, Left, 3cm, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 6/1/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 11/15/2018 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Targeted Therapy Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab)
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Aug 12, 2019 02:38AM - edited Aug 12, 2019 02:39AM by Olma61

Order online from Canada. (But this does seem risky for ER+ women)

10/30/2017 Xgeva for bone mets 5/31/2018 Taxol finished! "If one just keeps on walking, everything will be all right” - Kierkegaard Dx 8/3/2017, IDC, Right, 2cm, Stage IV, metastasized to bone, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 10/28/2017 Perjeta (pertuzumab) Targeted Therapy 10/28/2017 Herceptin (trastuzumab) Chemotherapy 10/30/2017 Taxol (paclitaxel) Hormonal Therapy 5/14/2018 Arimidex (anastrozole) Radiation Therapy 5/30/2019 External: Bone
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Oct 3, 2019 07:41PM Sonia1 wrote:

hi I was told I can’t take any type of hormone by my oncologist I was on them . Is the cream a homone? Curious

K
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Oct 3, 2019 08:12PM muska wrote:

I believe vaginal creams with low estrogen are considered an acceptable option if 'regular' lubricants are not providing the desired effect. I was told by my oncologist she would prescribe if I needed it. So far, I manage by using LiquiBeads two/three times a week.

Check this recommendation: Use of vaginal estrogen in women with history of breast cancer

Dx at 54 Dx 5/9/2013, DCIS/IDC, Right, <1cm, Stage IIIA, Grade 3, 7/11 nodes, ER+/PR+, HER2- (FISH) Surgery 6/12/2013 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Dx 6/13/2013, LCIS, Both breasts Chemotherapy 7/24/2013 AC + T (Taxol) Surgery 2/19/2014 Reconstruction (left); Reconstruction (right) Hormonal Therapy 3/11/2014 Arimidex (anastrozole) Radiation Therapy 3/22/2014 Breast, Lymph nodes, Bone
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Oct 3, 2019 11:30PM ksusan wrote:

My oncologist and an oncological gynecologist encouraged me to use it, but I won't.

Mutant uprising quashed. Dx 1/2015, IDC, Right, Stage IIA, 1/1 nodes, ER+/PR+, HER2- Dx 1/2015, DCIS, Left, Stage 0, Grade 3, 0/2 nodes Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal: Sentinel; Mastectomy: Left, Right Radiation Therapy Whole-breast Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Nov 12, 2019 11:05AM - edited Nov 12, 2019 11:14AM by wallycat

I am reading that vaginal 10mcg or 4 mcg pessories are acceptable; cream I was told is not "allowed" (my onco) as it can be upwards of 1mg. There are some articles showing that women on AIs show an increased blood level for the first 2 weeks on the inserts, but it comes down in most (though not all) women after 2 weeks. Still not as low as not taking anything, but there is quality of life.

I finally went on Imvexxy (it offered a mfg. coupon so made it $70/3 months) and am using as little as possible. For me, it was my bladder. It was quality of life....you can't leave the house and you have to pee constantly...it was ridiculous---never mind sleep!

I'll wean to the least amount and try to skip a month here and there. That will help with the financial and the health stuff.

The latest goodrx showed vagifem over 120

Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012

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