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Any help with financial assistance for CML medicine Sprycel?


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#1 JRH0602

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Posted 28 October 2011 - 02:32 PM

I am 35 years old and was diagnosd with CML (Chronic Myeloid Leukemia) at the beginning of August 2011. I am employed by our city as a police officer. We are given free insurance which is a self insured plan through Blue Cross Blue Shield of Florida. This insurance is not a good policy, but it is free. I was taken off the road by the department doctor and put in an office at the station due to my cancer. I was placed on trial of Sprycel to treat my leukemia, it worked perfectly. My oncologist was amazed at the results. I was given another 14 day sample while we waited for the insurance to process the prescription. I was without the Sprycel for 3 days while waiting on the second sample. I got down to 4 days of pills and was being notified daily by different insurance companie/pharmacies that my medicine is $8,000.00 a MONTH!!! I am now on my fourth day without medicince again. Who in this world can pay $8,000.00 a month for medicine? My insurance is saying that I have to pay my deductible of $1100.00, an out of pocket of $500.00 and the full $8,000.00 up front EVERY MONTH, then they will process the claim for a 70/30 reimbursement if approved. This is UNHEARD of!  I have contacted and applied to numerous assistance websites, cancer companies, drug companies, VA, Shands Hospital, NIH, etc and EVERY SINGLE ONE of them say, I am DENIED!! How, can I get my medicine??? I may have a free insurance plan that is given to me, but it DOESN'T COVER anything. Where do I go, what do I do to get help? Quit my job so can qualify for Medicaid? Does anyone have any information to help out with? I am desperate! Thank you in advance for any and all suggestions.



#2 mikefromillinois

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Posted 28 October 2011 - 04:08 PM

Hello JRH,

I am traveling the same road - diagnosed in July, BCBS insurance, on Sprycel for two months now.  My condolences.  It's hard enough to come to terms with being sick - having to spend the first month or two searching and applying for financial assistance is BRUTAL.  Assuming I stay on Sprycel ad infinitem, under my present insurance my total out of pocket per year will be $8,000.  I have managed to obtain a very small amount of assistance, but the current gap is more than I can afford.  I am still plugging away, hoping for the best.  If you'd like to compare notes shoot me (maybe not the right phrase to use with a police officer - haha) a private message and we'll go from there.

Hope you're feeling okay.  Take care and stay well...

Mike



#3 Marnie

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Posted 28 October 2011 - 06:35 PM

Hi, JRH. . .sorry to hear about your circumstance.  I understand your frustration on a much smaller scale, I I just dished out $4000 when I picked up my sprycel scrip and if I weren't able to switch to my husband's insurance, I'd be dishing out another $4000 in January.

Two suggestions. . .

1) Contact Bristol-Myers Squibb.  Most pharmaceutical companies offer assistance for people without insurance coverage, and it sounds like your plan does not cover prescriptions.

2) Contact MySprycelSupport (google it online).  Talk with someone who can give you names and phone numbers to call for assistance.  The MySprycelSupport program can also give limited coverage (covers up to $100 of your copay per month for a 12-month period. .. no help to you since you don't have a copay, since you don't have coverage), but they may be able to help.

You might also consider contacting the LLS.  They are a very supportive organization, though I think their funds are running short in this economic time.

Best of luck.  Hang in there.  Try not to get too scared or frustrated.  CML is pretty slow moving, and Sprycel is a very effective drug.  It will get your numbers down there while you deal with the financial/medication issues.  

One other consideration, if the financial piece doesn't work out.  Talk to your oncologist about switching to Gleevec.  It's less expensive, and will go off patent in a few years, reducing the price to something that might be reasonable.

Let us know how things work out.

Marnie



#4 WoofWoof

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Posted 29 October 2011 - 11:18 AM

JRH- The National CML Society has a page with several links that may be able to help you. All the best to you:

http://www.nationalc...stance-programs


I have cancer but it doesn't have me


#5 Susan61

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Posted 29 October 2011 - 11:25 AM

Hi:  I hope you get some help from someone.  It is insane at how you have to pay so much out for medication.  I have never been on Sprycel. I have always been on Gleevec which is Novartis.  The only way I got help at one time was because my husband was out of work, and they gave me my Gleevec free for the time that my husband was waiting to start a new job.  We do have prescription coverage with my husbands insurance, and always did.  I only have deductible on my regular medical care.  We had to get COBRA for the months that my husband was out of work with no lapse in medical coverage due to my CML, otherwise I would not be able to get new insurance for a pre-existing condition when he started his new job.  We were paying over $800.00 a month for the COBRA.  Keep searching for help.  There has to be something out there for you.

Susan



#6 Tedsey

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Posted 29 October 2011 - 12:28 PM

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."  It appears insurance companies are comfortably exempt from this upstanding moral standard.  http://en.wikipedia....of_Independence.  I guess it can be seen as "literary fluff", but I believe it and stand by it.  Although, arguably it is somewhat ambiguous, anything less is inhumane.

I am so sorry you have to go through all this.  But I feel you will find a way.  I have a huge deductible too.  If we weren't able to pay it out in installments with the online pharmacy, it would be really hard to afford the meds (i.e. LIFE,LIBERTY and the PURSUIT OF HAPPINESS).  And I have had the insurance company threaten not to send the life saving cancer drugs to me if I didn't pay up first.  Very depressing to deal with when you are first diagnosed.

I am angry and sad to hear the department doctor (who probably knows sh*# about leukemia or CML) put you at a desk (unless you are happy about this).  Unless you are experiencing severe side-effects that interfere with your job, there is no good reason why your position had to change at all.  I have been dx for almost 2 years.  I had some rough times getting adjusted to the meds, but now I don't even feel sick.  I feel great and I have gained weight and am physically strong.  I think I am stronger than I ever was.

Sending heartfelt best wishes to you.  Wish I could be more of a help.

Despite all these initial troubles, quick healing and long-life to you!

Tedsey 






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