Is The High Cost of Revlimid Too High For Multiple Myeloma Patients?

by Jane Ashley

We all know that cancer care is expensive. We see our individual bills for our type of cancer, and most of us struggle to pay it. But multiple myeloma patients are now facing a financial crisis with the cost of Revlimid, an oral medication used as a maintenance drug after an autologous stem cell transplant or for newly diagnosed patients who are not eligible for an autologous stem cell transplant. 

International Myeloma Foundation

Revlimid is very effective, but at what costs to the patient and their family? Financial toxicity for multiple myeloma is prevalent among these patients. With more and more new, more effective treatments becoming available for other types of cancer, including lung and breast cancer, the challenges facing multiple myeloma patients will likely become more common for many more of us.

Let’s look at the history of Revlimid (lenalidomide).

Revlimid is related to thalidomide, the anti-nausea medicine used to prevent morning sickness in the late 1950s and early 1960s. Researchers discovered in 2005 the potential that lenalidomide might have for the treatment of multiple myeloma. Celgene, a biotechnology company, began marketing Revlimid in 2006 as a treatment for multiple myeloma. When introduced, Revlimid cost $6,195.00 for 21 tablets, considered a month’s supply.

By 2010, the price had escalated to about $8,000/month. By April 2016, the price had reached $10, 691. And now for the sticker shock, in March 2017, the price had soared to $16,691. The reason that Celgene keeps raising its price for Revlimid is that it has no competition. Celgene has prevented generic competition through a vast complex of patents and grants of market exclusivity.

Revlimid brought in a record $8.1 billion, 63 percent of Celgene’s revenue in 2017. This seemingly impossible sales amount is all from a derivative of a 60+-year-old drug that was available over-the-counter in Europe before it was removed from the market because of the serious birth defects it caused.

So what can multiple myeloma patients do to get this life-saving drug?

Financial Aid

The WhatNext editorial team was just discussing the price increases of Revlimid and how some patients are considering discontinuing it as maintenance and taking their chances with what happens. Just that morning, I had read a short article on CURE Magazine about a patient who has been taking Revlimid for over four years.

Because Revlimid is an oral chemo, it’s covered differently, albeit, more expensive copays, because it’s covered under your prescription coverage. Regardless of whether you have private insurance, Medicare or Medicare Advantage, getting your pills on a regular basis can be financially and logistically challenging.

For those of you who have only had infused chemotherapy, oral chemo is covered by your prescription drug coverage. The patient has to pick it up and pay for it at that time. Sometimes, a local pharmacy chain may be able to supply it. But one of your best options is to have your oncologist call it into the pharmacy at the treatment center, aka medically-integrated dispensing. The pharmacists and insurance coordinators already know-how expensive the copays will be for their patients, and they are usually connected with a number of financial aid options. Private insurance patients usually qualify for financial assistance through the manufacturer. Medicare and Medicare Advantage patients usually qualify for a grant through a foundation.

Another benefit of a medically-integrated dispenser is that you’ll have a real person to talk to and who knows your medical history. They help coordinate the timely delivery of your oral chemotherapy. If your insurance changes, they jump in to help you continue to get your medication filled along with finding financial assistance.

What if there’s not a medically-integrated dispensing pharmacy available?

Several organizations offer private copay assistance. We sometimes have to be willing to do some of the legwork to get the medications we need.

Healthwell Foundation for Medicare recipients.

Leukemia & Lymphoma Society for patients with household income up to 500 percent of the Federal Poverty Level with private insurance.

Patient Advocate Foundation for patients with income below 400 percent of the poverty level.

Patient Access Network Foundation for patients with income below 500 percent of the poverty level and have either private insurance or Medicare/Medicare Advantage.

Income Limits

As you can see, the income limits are high enough that most patients can receive help. For an individual, one can make up to $48,560-$60,700 and still qualify for help. For a couple, joint income can be from $65,840-$82,300.

The Bottom Line …

Don’t throw up your hands in despair when you learn how much Revlimid costs. Don’t think about not taking it. Don’t contemplate stopping taking it after a year of maintenance. The odds are that almost every multiple myeloma patient can find the financial assistance they need to take this effective treatment.

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