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Old 10-15-2009, 09:04 AM   #51
chrisy
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Join Date: Sep 2005
Location: Central Coast, CA
Posts: 3,207
Re: Insurance Company Does Not Want to approve TYKERB

Sheila,
I agree, rattle as many cages as you can. In the meantime, could you pull it off financially paying for either the Tykerb/Xeloda or the Herceptin (since BCBSIL's issue seems to be paying for the combo) while you're working it. You know the insurance co is not paying what they are billed for the Herceptin - you might be able to work a deal with patient services to get a reduced rate.

It totally sucks - you do everything right: HAVE insurance all those years, bust your ass surviving as long as you have and now they poop on you. Your job is to fight - the disease, not your insurer! Theirs is to support that by paying for FDA approved therapies.

Sheila, a door will open - keep jiggling the handles.
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Chris in Scotts Valley
June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?"
9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++
10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!
04/05 - 4/07 Herception every 3 wks, Continue NED
04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial
06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin
01/08 Progression in liver
02/08 Begin (TDM1) trial
08/08 NED! It's Working! Continue on TDM1
02/09 Continue NED
02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED
12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver
07/11 - 11/11 Herceptin/Xeloda -not working:(
12/11 Begin MM302 Phase I trial - bust:(
03/12 3rd times the charm? AKT trial

5/12 Scan shows reduction! 7/12 More reduction!!!!
8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!)
9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3
11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc
11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go.
2/13 Gemzar/Carbo/Herceptin - no go.
3/13 TACE procedure
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