7 replies to this topic

[nathaliece]

Hi everyone --

My onc prescribed Zofran this week to help with the nausea and vomiting I had been enduring pretty consistently due to the 400 mg Gleevec.  Has anyone else tried this?  Did it work?  Also, the pharmacy called and notified me that the insurance company would only pay for 12 pills of the script for 30 pills.  I guess they think it is fine for me to puke 18 days of the month potentially.  Has anyone else had trouble getting insurance coverage for Zofran (or the generic form)?

I plan to contact the insurance company after I am sure the zofran is effective for me and explain the "economics" of their denial.  I understand that my the cost of zofran is about $100 a month.  If they don't want to cover it and the onc decides to switch me to Tasigna or Sprycel, it will much more than $100 more a month!   Geesh!

[janne]

I was hoping someone could answer with more specific information than what I have.  Perhaps you have already tried the Zofran and had good results. I know that Zofran in general is a very reliable anti-emetic. It is used for inpatients quite a bit and I do know also that there have been difficulties with getting insurance payors to cover it in all cases. I do not know if that is for specific outpatient uses, or what. I just know that with my experience in my job, but not personally. I am sorry you are having such difficulties with your medication. I would also suggest that you ask your doctor to write a letter on your behalf to your insurance company after you have tried the drug so that he/she can validate your need for it (if it is successful in treating your vomiting). Good luck to you ! Janne

[dee145]

I have used Zofran for over a year and it works wonders fro me.  I have tried to eat and take my Gleevec without the Zofran and I get sick to my stomach every time so my onc. tells me to just take it and not worry bout getting sick.  I take 8mgs around 30-45 mins. before my supper then I eat and also eat a yogurt after every meal.  Some one told me the yogurt thing along time ago and maybe it's all in my head but it works or I was told to eat choc. pudding after I eat.  But Zofran works for me, we just got new insurance and I have a new script and sure hope they give me enough for every day.  My old insurance did.  My onc. says not everybody is made alike so we can't all tolerate the gleevec alone plus I am not a real big eater all the time and I am built small compared to some one that is built bigger and can handle things better.  Plus I suffer from anxiety really bad, just had a attack a few weeks ago and my husband found me passed out on the floor in bathroom with a gash on my head so I don't need to worry about puking too.  I don't remember to much about passing out except I was trying to get wet wash rag cuz I was getting hot and next thing my husband was shaking me and I was in and out of it.  Had to go by ambulance, I didn't want to take xanax either because of fear of becoming addicted but I decided I am taking it, so be it if i become dependant on it.   Sorry i got off the subject but Zofran works for me!!!!!!!

                                                            Dee

[CMLMN]

I took zofran when I was on Gleevec 2 years ago and it did the trick.  I'm on Tasigna now and don't have nausea side effect anymore.  My insurance did cover zofran at that time but I think it was generic ondansetron (?).  I started taking 8mg but then I halved pill and it still helped the same way.  I even experimented with taking 2mg but it didn't work consistently for me.  good luck. 

[hannibellemo]

What are they saying? That there are generic drugs that do just as good a job and they want you to try them first? I guess I don't have a problem with that. In looking at my Rx formulary Zofran is in the third tier non-preferred brand, there is nothing in the 2nd tier and  there are 6 generics in the first tier. Have you tried any of them? If you can prove that they don't work for you you should be able to get Zofran. What did they say when you asked why only 12? Maybe they just want to make sure it works for you before they fill an entire Rx. Remember, most people don't take their drugs as prescribed - amazingly enough that is even true with our TKIs!

Is your company self-insured? In that case whoever is in charge has the ability to over ride their own policies, that has been done at my workplace. You may want to talk to HR or whomever about it.

Learn as much as you can about your insurance policies and benefits - I was amazed at what I did not know. No, I don't work for an insurance company and I'm not defending them, I just had to get up to speed real quick when we changed administrators last July.

Good luck!

Pat

[nathaliece]

Pat --

I wish it was that simple.  I have been in "Pharmaceutical Hell" for the past week.  My prescription was for the generic Zofran  and they will still only approve 12.  I am working on appealing that but wanted to make sure the drug worked for me first.

It only got worse yesterday.  I have my Gleevec delivered to my office so that someone can sign for it rather than leave it on my front porch.  I get it from Diplomat Pharmacy.  Well typically, I have it delivered when I have 4 or 5 days of pills left but I asked that it be delivered yesterday instead of last Thursday or Friday because we were moving our office and I could foresee a potential "cluster".  Well, guess what, UPS delivered my drug to the wrong address ... and the person who received it opened it!  So I ran out of 100 mg pills this morning, still have to take a dose for tonight and have a lovely bone marrow biopsy in the morning.  The earliest the pharmacy can deliver the replacement drug is tomorrow morning.  I called the oncologist and explained my plight.  I still have some of the "big" 400 mg pills that I used to take (and REALLY made me hurl) and so the oncologist said to cut one in half and take it tonight with double the dose of zofran and hope for the best.  Argh!

Thanks for letting me vent,

Nat

[dee145]

Well, we are in the same boat.  My onc has my script wrote to take 2 generic Zofrans but insurance would only give me half of that so I have to go every 2-3 weeks depending on if I have to take 2 if I eat a light meal or 1 if its a big meal.  But I don't have a co-pay now which I don't understand.  My pharmacist is checking with the insurance on why they do it this way and if there's another way to do it.

                                                           Dee

[CMLMN]

Could it be that there is a shortage of zofran generic?  There was something in the news about shortage of different drugs because they don't bring in enough revenue and companies discontinue them.  Not sure how you could check what is on the shortage list.