7 replies to this topic

[cgrave2]

I was dx'd on 10/2010 with CML. I started Tasigna in Dec 2010 through the Patient Assistance program thru Novartis. This continued for the last 2 yrs. but I have just be denied. My husband and I are self- employed and under insured with no coverage for dr visits, labs, and prescriptions. I do not qualify for other govt assistance, nor can I increase my insurance coverage because of  my dx. Has anyone else been in this position, and if so, what to do? My local Walgreens wants over $10,000 and a Canadian Pharmacy costs are $5000. I have appealed to Novartis but the appeal process can take up to 6 weeks and I have 12 days of meds left!!!!

[Taylor]

Man, I am sorry to hear that.  Did they say why they denied you?

[cgrave2]

We make too much money!  Our business showed a small profit for 2011 and it obviously put us just over their income limit. What they don't understand is nobody can afford Tasigna at over $10,000 a month! I found it on a Canadian pharmacy for around $5000 but who can afford that? Being self employed, we couldn't afford full coverage insurance, and after my dx, no insurance company would touch me!

[ritan/]

i've no idea if this is an option, BUT: have you considered a different type of insurance coverage? we have expensive self-coverage that pays nothing for the first $5000, but then covers everything.  what about your state's high risk pool of insurance?

[cgrave2]

I applied today actually to the Pre- existing Condition Insurance plan in my state. But, I have to be without insurance for 6 months first. Which means I may have to give up my hospitalization only insurance and wait the 6 months.

I have my doctor and a representative from the Max Foundation helping me to appeal to Novartis and to procure some Tasigna to get me through this transistion.

[NotJack?]

I was in your spot too.  A couple of thou over the assistance level at Novartis.  Applied for high risk insurance, and told that I had to wait 6 mo.  Had 3 mo. free deal through Novartis.  Novartis will relent, and, at least in MN, they kicked in the insurance within 3 mo.  It is stressful, but Novartis knows that if you can get past that insurance time barrier, you are good for $100,000+ a year to them.  It seems to be a game to them to find out who will subsidize the first 6 mo.  It is in their best interest to get you started on Tasigna before Gleevec becomes generic.  Keep calling the insurance company that administers the program, and ask to speak with the management.  E-mail the CEO and other officers.  Contact your state representative.  State insurance commission. Your cancer team should also have a person on staff to help.  Rally the troops. Be the squeaky wheel.  It probably cost me ten years of life in stress, but now I am covered thanks to Sen. Martin Sabo, who made the insurance companies who operated in our state provide insurance to pre-existers at no more that 125% over what a normal person would pay.

[markmendonca]

if u r from Mass. give me a call i think i can help u 978-836-8192 ....sorry my name is mark i cant spell well thats y i like the phone lol....God Bless

[jimstealth]

call me wen 27th @ 631-942-9092 in eve. -jim-