Neulasta Questions

I have just got through 2 treatments of Adryiamycin/Cytoxin for stage 1 Her 2+ Grade 3. I have very bad insurance. Just got my bill today for over 10,000. The big cost was the Neulasta shot that I receive the day after chemo. It was 4,000 each time. I was told that if iIdidn't get this shot that my white blood count would drop & I would get sick easy. My queston "Is this shot necasary?" Does everyone else on here get that shot after this particular chemo regimen? Would really like to know if I need it or not because I'm going to be in the poor farm before long at this rate. Thanks for any input please. Barb

[Lolly]

Hi Barb,

Welcome...

In some cases, depending on your policy, insurance coverage of additional chemotherapy-related medications may need to be "pre-approved" by your doctor. It should be covered if it's felt to be "medically necessary", and what your ins. company requires in the way of documentation should be investigated by your doctor's office support staff. Ask them if they will pursue this for you, as being a patient under treatment you should not be expected to take care of this complicated issue on your own. Also, don't pay the current bill in question until this is settled with your insurance, as your doctor's office may be able to get insurance to cover after the fact.

I recently completed 6 months chemo for recurrence, and needed a red blood cell booster for the last 3 months. It was covered by my insurance.

Good luck and God Bless.
Lolly

[Ray]

Hi Barb-

Are you receiving this treatment every two weeks, or how often? Will this be followed with treatment with the chemo drug Taxol? My wife (stage 3 Her 3+ Grade 2) received Adryiamycin/Cytoxin every three weeks. She did not need anything to boost her immune system, but would have needed the Neulasta shot had she received treatment every two weeks. (The two week interval is known as "dose dense". It was thought to have a better response rate in fighting the cancer than the standard protocol of receiving the drugs every three weeks since you receive more of the chemo to fight the cancer in a three month period.) However, it has been learned that the benefits of "dose dense" treatment with Adryiamycin/Cytoxin followed with Taxol was really in the Taxol and not in the other two drugs. Therefore, the treatment has been changed in a lot of cases to three week intervals with the A/C, followed with weekly reduced-dosage treatments of Taxol. This eliminates the need for the Neulasta shots for many of the patients who are being treated with the Adryiamycin/Cytoxin/Taxol regimen. This may be something to discuss with your oncologist (if you happen to be on this particular regimen.)
Best of luck,
Ray

Ask your Onc about Nuepogen which is a lot cheaper than Nuelasta. The disadvantage is that Nuepogen has to administered daily.

Hope this helps