Cost of Tykerb and Xeloda

Joan M · 03-08-2011, 07:07 AM

Hello fellow survivors,

I'd appreciate your input.

What does it cost each for prescriptions of Tykerb and Xeloda in a private insurance plan (that is, not Medicare, Medicaid, or other state-sponsored insurance)? And for how long does a prescription last.

Somebody was recently asking me about the cost, because these two oral chemotherapies fall under the prescription coverage of private insurance, not the medical coverage under which infused chemo falls.

Thanks,

Joan

pibikay · 03-08-2011, 07:28 AM

Dear Joan
This is from Chennai(Madras)India.The Onc prescribes a two month dosage4 Tykerbs a day & 4 Xelodas a day.Xeloda one wek on one week off.The cost when converted to US$ comes to 2250$ for a two month course.Our mediclaim was exhausted last year mid way of the herceptin regime and I have made a claim for the first two months of Tykerb and Xeloda (of 2011) to the TPA of the insurer and I am awaiting a reply
Wish you all the best

Joan M · 03-09-2011, 07:06 AM

Does anybody else have anything to add about these costs?

I'm heading to Albany, New York's state capitol, on March 15 for New York State Breast Cancer Education and Advocacy Day with several other women. I have 20-minute appointments with different legislators from the five boroughs of NYC to discuss two bills. One bill involves giving parity to oral and infused chemo drugs. Other states have similar legislation. For purposes of this legislation, oral chemo also includes endocrine drugs like Tamoxifen and aromatase inhibitors. So any information on the cost of those drugs would also be useful. I asked about Tykerb and Xeloda because that affects all HER2+ metastatic survivors, and being metastatic I've been asked to present that case. But the issue also involves early stage patients, as there are an estimated 400 anti-cancer drugs in devlopment and 25% of them are planned as oral drugs.

While infused chemo is paid for by the medical portion of private insurance, oral chemo is covered by prescription plans and have hefty out-of-pocket expenses, and we need to change that.

Thanks.

Joan

Sheila · 03-09-2011, 07:48 AM

Joan
I used to pay a nominal fee for Tykerb and Xeloda, like 20.00 per month. We have to get all oral drugs through a mail order pharmacy like Caremark or Curascript....it recently changed to Curascript, which is a pain to get anything from. My Neupogen shots are now 30.00 for 5, and I have been fighting over the phone (and so has the Dr's office ) with Curascript, to get the prescription filled as today is the day I take them again. Dont know if they will arrive or not. I have no idea what Tykerb would cost from them, I just know ordinary drugs have tripled since last year.

PinkGirl · 03-09-2011, 07:49 AM

For all it's worth ... it's the same in Canada. Chemo infusions are
part of the universal health plan ... pills are covered by private drug
plans which not all people have.

Ceesun · 03-09-2011, 08:34 PM

Joan, I know that this is not exactly what you want, but just an fyi...my Tykerb co pay is $36. per month through the state teachers' retirement plan...before I retired, it was $12. Ceesun

SoCalGal · 03-09-2011, 10:31 PM

Thanks for fighting for us, Joan!! I recently wrote an op ed piece in support of Avastin, and it was just picked up by local small newspapers. It's important to keep our voices heard.

Joan M · 03-10-2011, 07:39 PM

Thanks for your input. It's very helpful. I've also received a few other personal e-mails.

Pink and PBK thanks for your information about Canada and India.

Sheila, you deserve a medal for dealing with insurance companies!

Joan

schoolteacher · 03-11-2011, 06:45 AM

Thank you, Joan.

Amelia

Lindy · 08-22-2011, 05:34 PM

I'm discouraged, the difference in co-pays for Tykerb (mine would be $1600 per month) makes me wonder why my $90 a month medicare part D is so useless on this one. I was so careful not to fill any "frivolous" meds to preserve my plan and now I need to spend $600 out of pocket to qualify just to submit a request for assistance. The first month of Tykerb would instantly put me in the donut hole.

08-29-2011, 12:28 PM

I recently came off of Xeloda and Tykerb, didn't work as my mets in my lungs progressed. As a Canadian in Ontario, the Xeloda is paid for under our provincial health care,but the Tykerb is not. The cost was $2800. every three weeks. My private insurance covered this for the 2 and 1/2months I was on it. Initially I was good for one year, then out of pocket. Some of our other provinces cover it, but not Ontario........still under revue.

I'm now on my second treatment of Naveline.

Gail

Mary Jo · 08-29-2011, 02:08 PM

Thanks Joan for doing this for all of us. You're a SPECIAL blessing among us here.

Love and God's wonderful peace be with you.......

Mary Jo