Pertuzumab not avaliable to stage 4 contrary to what you have heard

[7andcounting]

No, my onc is still working on this. The way this has been approved is making this very difficult to get. I think people are told it is covered but until they get their EOB's back there is no way to know, unless you have a letter stating that coverage is garunteed before you start.

[Nancy L]

Is there such a thing as getting a drug like Pertuzumab off label with Medicare? Has anyone ever been successful?

[Sheila]

Unfortunately, most of us who need this drug as a last ditch effort, need to get it off label. Anyone who has already been treated for metastatic disease would not qualify under the FDA guidelines right now. By it being given off label, the onc. Does not have to give it with chemo, but can give it with Herceptin. I do know that where I receive treatment, 3 different breast oncologists have applied for this for 13 patients total, and so far I am the only one getting it. The insurance company itself can be a go or a no, depending on type of insurance (so unfair). I do know that mine was applied and ordered for MEDICAL NECCESSITY. Still do not have payment...they approved it, but that is no guarantee they will,pay for it and sent me a letter as such. The insurance people at my hospital said it is usually not able to,process off label drugs through medicare, and there are penalties that apply if they do...somifmone is on Medicare, it might need to be requested through secondary insurance if available. Hoping everyone who needs this drug is able to get it, and that it works. So far, I have only had one dose and I see no change....hoping dose #2 will show a big change when given with Herceptin...that is next week