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Nanjeanne

(6,804 posts)
51. I am so sorry you are going through this but I can certainly empathize. My husband has an incurable but
Sun May 4, 2025, 03:54 PM
May 2025

"manageable" blood cancer. It basically means that he will go on a drug or therapy, get remission for a certain number of months (or years) and then relapse. He's been living with this for 11 years with many relapses. At one time, after his stem cell transplant in 2015, he was on a maintenance drug for 4 years. Because the maintenance drug was in pill form - at home - it's not covered by Medicare but by the "Medicare" Drug plan (I use quotes because this is simply called medicare drug plan - but all drug plans are run by private insurance). His copay each month (after insurance paid their part) started at $600/month and then every year after it went up - so by the time he relapsed after 4 years and went on a different treatment - his copay was $960/month! No way could we afford that. But because he was on Medicare (not private insurance) he wasn't eligible for discounted help from the pharmaceutical company. I know - crazy but because Medicare is a federal program - even though the drug plan was private - it's only offered to Medicare participants so considered federal. Our only solution - and perhaps something you can consider if you are in the same boat - was to get a grant from various patient advocacy groups. When he started this route - we would get a $10,000 grant which covered the copays for one year. By the time we finished with this drug - we were getting an $11,000 grant and that covered less than a year and we were forced to go find another grant if we could from another organization.

It's a horrible system and something no person facing serious illness should have to navigate. Usually a cancer hospital will have a social worker or pharmaceutical advocate that can help you. Reach out to your team and also search for patient copay grants for your particular illness and see which organizations might be able to help you. If you are not on Medicare - you can try reaching out to the pharmaceutical company for their discount help.

Some organizations we received copay help from were:
Lymphoma and Leukemia Society - probably only works for blood cancers
Patient Advocate Foundation
Healthwell Foundation
And check with American Cancer Society

I wish you well.

Recommendations

0 members have recommended this reply (displayed in chronological order):

it is EXTORTION Skittles May 2025 #1
That was my first reaction, too! herding cats May 2025 #2
Sometimes big Pharma companies say in their ads that spooky3 May 2025 #3
I Did ask, as the $500 a month before the Avastin is added in is too much. herding cats May 2025 #5
Sorry to hear that. I hope there is change before August. Nt spooky3 May 2025 #10
Thank you. herding cats May 2025 #11
Can you get on disability and get Medicaid. I don't know if they would pay for expensive drugs. kerry-is-my-prez May 2025 #65
I hope things work out, too. 🙏🙏🙏💙💙💙 LiberalLoner May 2025 #45
Sorry if these suggestions are futile, snot May 2025 #4
Appreciate the suggestion. herding cats May 2025 #7
Ugghh! snot May 2025 #20
My RA treatment costs enigmania May 2025 #6
WTF Skittles May 2025 #8
How can you afford that?! herding cats May 2025 #9
I get samples and hope for the best. enigmania May 2025 #54
It's so far beyond not right. It's inhumane. Phoenix61 May 2025 #12
Inhumane sounds right. herding cats May 2025 #16
I am so very sorry Mountain Mule May 2025 #22
We need to do something and stop with the 'speaking'. OldBaldy1701E May 2025 #46
That's horrible. I am so sorry you are facing this. It isn't right, at all. 58Sunliner May 2025 #13
That is obscene. I sure hope you don't lose your insurance. May The Universe protect you. LoisB May 2025 #14
Oh, herding cats, this is insane. And the idea brer cat May 2025 #15
I hope you know you're always a light in a dark moment? herding cats May 2025 #17
(blushing) brer cat May 2025 #19
I can't imagine doing a go fund me. herding cats May 2025 #25
Could you appeal to a neighboring Rep for help? calimary May 2025 #28
I live in Texas. herding cats May 2025 #31
Maybe Jasmine Crockett could draw attention to your plight and shame your rep into helping catrose May 2025 #56
Well, you just hold tight and keep good thoughts at the top of your mind. calimary May 2025 #59
❤️ littlemissmartypants May 2025 #18
I appreciate this! herding cats May 2025 #23
Can Mark Cuban system help? question everything May 2025 #21
I haven't thought of him until you mentioned it. herding cats May 2025 #24
Just a thought. Ask Mark. He's a much better person than most entrepreneurs. usonian May 2025 #33
I appreciate what he's doing, but I believe it's only for generic drugs that aren't "controlled" (needing a LauraInLA May 2025 #52
I wonder if you have what my wife had? DFW May 2025 #26
Check if there are mfgr coupons, rebates, discounts, etc. Eliquis, Cequa and a bunch of others have them. TheBlackAdder May 2025 #27
I am sorry to hear what you are having to go through to stay alive. sheshe2 May 2025 #29
Yea DENVERPOPS May 2025 #30
Pharmacy tech here... buzzycrumbhunger May 2025 #32
The whole system is corrupt. Bayard May 2025 #36
Agree mainly. But the prices charged are more based on profits/marketing/etc. than costs of research. erronis May 2025 #55
I just took that eye drop (Xdemvy) virgdem May 2025 #38
Sounds like it would be cheaper Figarosmom May 2025 #34
Hi from Ukraine purrmaid May 2025 #39
The chemical structure of Olaparib/Lynparza isn't that complicated. eppur_se_muova May 2025 #35
Not sure that is simple IbogaProject May 2025 #50
To an organic chemist, it's pretty simple. No chiral centers. No fused rings. Two amide bonds. A hydrazone. eppur_se_muova May 2025 #57
Ok so price gouging IbogaProject May 2025 #60
That's kind of weird, since it's a small molecule drug. However, I didn't know there was an effective treatment... NNadir May 2025 #37
I've got you beat with Nucala injections. pandr32 May 2025 #40
It costs 20k/month for my moonscape May 2025 #41
💔 It's terrifying, is what it is. Heartfelt hugs, hopes, wishes for your & our collective future ❤️ Hekate May 2025 #42
Ohh Cat, It's So Heartbreaking Cha May 2025 #43
Another option not mentioned above TommyT139 May 2025 #44
Thank you for raising the issue and good luck to you ❤️ surfered May 2025 #47
The prices are all a scam - TBF May 2025 #48
So sorry 🤗🤗🤗 😢 Meowmee May 2025 #49
I am so sorry you are going through this but I can certainly empathize. My husband has an incurable but Nanjeanne May 2025 #51
I think this is why Linda ladeewolf May 2025 #53
I hope Medicare is not too distant in the future for you wolfie001 May 2025 #61
Wouldn't you be eligible for the ACA? DET May 2025 #58
And yet, instead of asking what drove Luigi to his act of violence against the United Health Care CEO, PatrickforB May 2025 #62
So beyond sick of medicine rip offs, don't citizens help with this R&D often? Brainfodder May 2025 #63
Damn Solly Mack May 2025 #64
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