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Lolly · 05-12-2007, 08:18 PM

Elaine, I have Medicare and my prescription plan considers it a Tier 4 prescription so it's at the highest co-pay, 25% for me (total monthly cost of Tykerb is around $3,000). On top of that, even with my plan paying 75% I was thrown into the Coverage Gap, aka The Donut Hole, and my total out-of-pocket for this first month was almost $1,500. Next month I will have to pay $700-$800 before I reach the maximum out-of-pocket of $3,800 and then after that the plan will pay 95% so my share will be $170-$180.

It's a shame the government is allowed to dump the cost of chemo drugs on those least able to afford them, just because they're oral not IV!

Sorry to be the bearer of bad tidings, but TykerbCares does have a Patient Assistance program to help bear the cost.

<3 Lolly

05-12-2007, 08:18 PM	#17
Lolly Senior Member Join Date: Aug 2001 Location: Oregon Posts: 1,756	Elaine, I have Medicare and my prescription plan considers it a Tier 4 prescription so it's at the highest co-pay, 25% for me (total monthly cost of Tykerb is around $3,000). On top of that, even with my plan paying 75% I was thrown into the Coverage Gap, aka The Donut Hole, and my total out-of-pocket for this first month was almost $1,500. Next month I will have to pay $700-$800 before I reach the maximum out-of-pocket of $3,800 and then after that the plan will pay 95% so my share will be $170-$180. It's a shame the government is allowed to dump the cost of chemo drugs on those least able to afford them, just because they're oral not IV! Sorry to be the bearer of bad tidings, but TykerbCares does have a Patient Assistance program to help bear the cost. <3 Lolly __________________ Sept.'99 - Dx.Stage IIIB, IDC ER/PR-, HER2+++ by IHC, confirmed '04 by FISH. Left MRM, AC x's 4, Taxol x's 4, 33 Rads, finishing Tx May 2000. Jan.'01 - local/regional recurrence, Stage IV. Herceptin/Navelbine weekly till NED August 2001, then maintenance Herceptin. Right Mast. April 2002. Local/Regional recurrence April '04, Herceptin plus/minus chemo until May '07. Gemzar added from Feb.'07-April '07; Tykerb/Abraxane until August '07, back on Herceptin plus Taxotere and Xeloda Sept. '07. Stopped T/X Nov. '07, stopped Herceptin Dec. '07, started Avastin/Taxol/Carboplatin Dec. '07. Progression in chest skin, stopped TAC March '03, started radiation. Herceptin has served as the "Backbone" of my treatment strategy for over 6 years, giving me great quality of life. In 2005, I was privileged to participate in the University of Washington/Seattle HER2 Vaccine Trial.