• IBRANCE

    Asked by Saddie on Tuesday, October 23, 2018

    IBRANCE

    Does Medicare cover IBRANCE. If not what is the financia ramifications?. My oncologist wants to put me on IBRANCE but I'm extremely concerned about the cost

    6 Answers from the Community

    6 answers
    • JaneA's Avatar
      JaneA

      Ask your oncologist to put you in touch with the insurance coordinator. Together, you should be able to work out the details for copay assistance. There is help for people on Medicare - from the pharmaceuticals, private foundations, and other sources. Concentrate on getting the logistics worked out so that you can get the help you need. Best wishes to get this worked out quickly.

      https://www.ibrance.com/financial-assistance

      27 days ago
    • carm's Avatar
      carm

      Go to a website called NeedyMeds... Google it and when you get on the site, click on menu, then patient savings. Then click just below that to brand name drugs. Click on the letter I for instance then scroll down and click on the name inFrance. If there is a picture of 2 capsules there is a patient assistance program t Hf at will pop up when you click on the pill icon. If there is a scissor and dotted line icon then that is a coupon, a savings card for commercially insured patients. You call that number and they will send you the discount card. I hope this helps you.

      27 days ago
    • Kayelen's Avatar
      Kayelen

      Pfizer has a program to help with payment for ibrance. If you do not have an insurance coordinator to help, google Pfizer ibrance help, and you should be able to get to a phone number or website that can help you apply for the assistance program. I started my program with ibrance and it was very helpful for me. Had a little trouble getting use to the medication but eventually was able to handle the med.

      27 days ago
    • ChicagoSandy's Avatar
      ChicagoSandy

      Sorry, but the above answers are incorrect (at least in part) as to Medicare coverage of Ibrance.

      Most Medicare Part D programs treat Ibrance as a "specialty drug" for which you need "prior authorization," so get on your doctor ASAP to start the process now. Usually, your co-pay will be 1/3, which for Ibrance is still pretty steep.

      You can't use anufacturers' co-pay coupons unless you have commercial--not government-subsidized--insurance. (And even if you're paying for a commercial insurance company's Part B, D or Advantage supplement, that doesn't count as "commercial"). The reason is because the Medicare statute forbids patients from using them. (Drug companies can afford these coupons because insurance companies subsidize them in return for kickbacks to "pharmacy benefit managers;" but neither Medicare nor commercial Part D do).

      There are workarounds. For Medicare patients, there are prescription assistance programs administered by both manufacturers and your state--BUT there is a very low income cap, above which you're not eligible.

      GoodRx.com coupons can be used by anybody--and their site will advise you as to which will be cheaper: your Part D co-pay or the GoodRx coupon price. If you use a GoodRx coupon, though, it does not count towards kicking you into (or pulling you out of) the coverage-gap "donut hole." If you didn't buy Part D but have any other Medicare, you're on your own--you can use GoodRx coupons but still not manufacturers' co-pay or discount coupons.

      There are private foundations & charities that can help defray part of the cost--some have strict income caps, but others may take your word for it that the only way you can afford Ibrance is with their help (they are more realistic about how well people can get by on a given income). If you are a member of a church such as LDS or another faith-based community, they may have no-questions-asked assistance as well.

      There's Canada (not the online--mostly shut down after the FDA threatened to sue them--but brick & mortar pharmacies). Most if not all brand and generic drugs are cheaper there. You will need to fill the prescription in person, and the prescription must come from a Canadian doctor (some will, if your U.S. doctor faxes one to them or you bring it with you, re-issue one themselves). And it's technically illegal for U.S. citizens to bring back into the country prescription drugs purchased in a foreign country.

      That law is almost never enforced--there are regular bus trips for seniors living in or near border states to visit Canadian doctors & pharmacies; and many tourists buy stuff abroad like Voltaren gel, Ventolin inhalers, Celebrex & the like which are not only way cheaper but often sold over-the-counter in the E.U. Unofficial Federal policy is to look the other way & let you bring in a reasonable quantity for short-term personal use. (That's not the kind of "drugs" that Customs & Border Control are looking for anyway).

      27 days ago
    • Kayelen's Avatar
      Kayelen

      just to follow up. You will need to provide proof of income for either a grant or assistance from the drug company in order to get help with the cost of ibrance. I am not sure what is considered to be eligible income but its worth a shot. I know this is true as I am currently working with Lilly for assistance with verzenio (which is kicking my but). I hate this medication. Pfizer also has assitance programs. Hopefully your oncology group will have an insurance assistance department which will take care of getting this done for you.

      27 days ago
    • ChicagoSandy's Avatar
      ChicagoSandy

      Consumer Reports online has archived an article about how to get help with the cost of prescriptions if you're on Medicare. Pretty much says what Kayelen and I posted.

      26 days ago

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