I am currently on a maintenance program of Velcade (injectable) and dex, taken 3 times per month on a schedule of Day 1, 8, 15. The cost of this treatment is completely covered by Medicare / Supplemental Insurance under Part B.
Last week, my oncologist introduced Ninlaro, which is an oral equivalent of Velcade. Obviously, my life would be simpler with an oral medication. However, Ninlaro is priced at $2,800 / pill or $8,400 / month and covered under Part D Medicare. I will be checking how much my Medicare prescription drug plan will cover, but I'm sure that I'll still be left with a substantial monthly bill.
Does anyone have experience with Millennium's 1 Point Plan for financial assistance? I understand that Velcade may come off patent in 2017, so I'm sure Millennium would like to see patients switch to Ninlaro.
At this point, I'll stick with the injectable Velcade if I have to pay significantly more for Ninlaro.
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LarryGaito - Name: Larry Gaito
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: June 2007
- Age at diagnosis: 62
Re: Ninlaro (ixazomib) insurance coverage
Larry,
That really is an awful policy with regard to oral cancer therapy and Medicare. My understanding is that the outdated policy for charging more for oral cancer therapy versus IV cancer therapy is changing fairly rapidly for private insurance on a state-by-state basis, but that doesn't help you with Medicare.
With Velcade and ease-of-administration, you might want to look at Coop's thread for self-administering Velcade (this is a route I will pursue if I ever go on subq Velcade):
"Self-injecting Velcade - my experience" (forum thread started Aug 17, 2014)
However, I really don't know how Medicare would treat the Velcade billing in this kind of home-administered situation. Would it be considered IV or Part D?
That really is an awful policy with regard to oral cancer therapy and Medicare. My understanding is that the outdated policy for charging more for oral cancer therapy versus IV cancer therapy is changing fairly rapidly for private insurance on a state-by-state basis, but that doesn't help you with Medicare.
With Velcade and ease-of-administration, you might want to look at Coop's thread for self-administering Velcade (this is a route I will pursue if I ever go on subq Velcade):
"Self-injecting Velcade - my experience" (forum thread started Aug 17, 2014)
However, I really don't know how Medicare would treat the Velcade billing in this kind of home-administered situation. Would it be considered IV or Part D?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Ninlaro (ixazomib) insurance coverage
hI Larry, here is some information regarding the expiration of patent for Velcade in 2017:
http://www.drugs.com/availability/generic-velcade.html
Velcade already has a generic version in Canada, by Teva.
It seems a shame that oral chemotherapies sometimes are not covered for patients, since they are more convenient, and do save the health care systems money, in that the patient does not have to go to an infusion centre to receive the drug. This is a matter of patient advocacy, which I think is going on now in the US. Maybe others would know more about that though.
http://www.drugs.com/availability/generic-velcade.html
Velcade already has a generic version in Canada, by Teva.
It seems a shame that oral chemotherapies sometimes are not covered for patients, since they are more convenient, and do save the health care systems money, in that the patient does not have to go to an infusion centre to receive the drug. This is a matter of patient advocacy, which I think is going on now in the US. Maybe others would know more about that though.
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Ninlaro (ixazomib) insurance coverage
Hi Larry,
My husband just started Ninlaro but he's not on Medicare (we have Blue Cross Blue Shield). The drug manufacturer for Ninlaro has a copay assistance program (link), but the eligibility requirements state patients who have Medicare are not eligible:
Have you applied for financial assistance with the Leukemia and Lymphoma Society (link)? They have a copay assistance program and perhaps you would be eligible through them.
Best wishes,
Chris M.
My husband just started Ninlaro but he's not on Medicare (we have Blue Cross Blue Shield). The drug manufacturer for Ninlaro has a copay assistance program (link), but the eligibility requirements state patients who have Medicare are not eligible:
Eligibility requirements: This offer cannot be used if you are a beneficiary of, or any part of your prescription is covered by: (1) any federal or state healthcare program (Medicare, Medicaid, TRICARE, etc), including a state pharmaceutical assistance program, (2) the Medicare Prescription Drug Program (Part D), or if you are currently in the coverage gap, or (3) insurance that is paying the entire cost of the prescription. Patients must be at least 18 years old.
Have you applied for financial assistance with the Leukemia and Lymphoma Society (link)? They have a copay assistance program and perhaps you would be eligible through them.
Best wishes,
Chris M.
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Chris M
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