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CVS Cuts Coverage of Dozens of Drugs in Exclusion Expansion


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#1 Buzzm1

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Posted 02 August 2016 - 04:15 PM

CVS Cuts Coverage of Dozens of Drugs in Exclusion Expansion

 

CVS Health Corp. will add 35 products to its lists of excluded drugs in 2017 and no longer cover some treatments for cancer and diabetes, in an aggressive move to favor lower-priced treatments and target what the company called "hyperinflation" of some other products.

 

The drug benefit manager will remove coverage for Novartis AG's leukemia treatment Tasigna, Medivation Inc.'s prostate cancer drug Xtandi, and Sanofi's insulin Lantus, expanding the company's strategy of excluding expensive products when alternatives are available. The total number of excluded drugs for 2017 will be 131, spokeswoman Carolyn Castel said Tuesday.

 

It's the first time that brand-name cancer drugs have been taken off CVS's standard formulary, Castel said in an e-mail.

http://www.bloomberg...7-covered-drugs


For the benefit of yourself and others please add your CML history into your Signature

 

02/2010 Gleevec 400mg

2011 Two weakly positives, PCRU, weakly positive

2012 PCRU, PCRU, PCRU, PCRU

2013 PCRU, PCRU, PCRU, weakly positive

2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)

2015 300, 250, 200, 150

2016 100, 50/100, 100, 10/17 TFR

2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000

2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17

 

At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.  

 

In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.  

 

longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation.   GFR and creatinine vastly improved after stopping Gleevec.

 

Cumulative Gleevec dosage estimated at 830 grams

 

Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.  

 

Trey's CML BlogStopping - The OddsStop Studies - Discussion Forum Cessation Study

Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt


#2 Buzzm1

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Posted 02 August 2016 - 05:43 PM

The exclusion of Tasigna coverage, by CVS, is coincident with the expiration of Sun Pharma's six-month U.S. generic Imatinib exclusivity.  The price of generic Imatinib should begin to decrease substantially as other manufacturers enter the market.


For the benefit of yourself and others please add your CML history into your Signature

 

02/2010 Gleevec 400mg

2011 Two weakly positives, PCRU, weakly positive

2012 PCRU, PCRU, PCRU, PCRU

2013 PCRU, PCRU, PCRU, weakly positive

2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)

2015 300, 250, 200, 150

2016 100, 50/100, 100, 10/17 TFR

2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000

2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17

 

At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.  

 

In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.  

 

longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation.   GFR and creatinine vastly improved after stopping Gleevec.

 

Cumulative Gleevec dosage estimated at 830 grams

 

Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.  

 

Trey's CML BlogStopping - The OddsStop Studies - Discussion Forum Cessation Study

Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt


#3 Harper3994

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Posted 02 August 2016 - 07:39 PM

Do you think this will start happening with other plans?

#4 Buzzm1

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Posted 02 August 2016 - 08:22 PM

Do you think this will start happening with other plans?

 

We discussed this a little on an earlier thread.  It's likely that insurers will try to encourage oncologists to first prescribe the less expensive generic Imatinib for newly diagnosed CML patients.  I don't think that patients already on patented meds will be effected.


For the benefit of yourself and others please add your CML history into your Signature

 

02/2010 Gleevec 400mg

2011 Two weakly positives, PCRU, weakly positive

2012 PCRU, PCRU, PCRU, PCRU

2013 PCRU, PCRU, PCRU, weakly positive

2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)

2015 300, 250, 200, 150

2016 100, 50/100, 100, 10/17 TFR

2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000

2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17

 

At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.  

 

In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.  

 

longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation.   GFR and creatinine vastly improved after stopping Gleevec.

 

Cumulative Gleevec dosage estimated at 830 grams

 

Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.  

 

Trey's CML BlogStopping - The OddsStop Studies - Discussion Forum Cessation Study

Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt


#5 rcase13

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Posted 02 August 2016 - 10:34 PM

Well that is not good. I take Tasigna and have CVS CareMark as my drug plan. Does that mean I have to switch?

10/01/2014 100% Diagnosis (WBC 278k, Blasts 6%, Spleen extended 20cm)

01/02/2015 0.06% Tasigna 600mg
04/08/2015 0.01% Tasigna 600mg
07/01/2015 0.01% Tasigna 600mg
10/05/2015 0.02% Tasigna 600mg
01/04/2016 0.01% Tasigna 600mg
04/04/2016 PCRU Tasigna 600mg
07/18/2016 PCRU Tasigna 600mg
10/12/2016 PCRU Tasigna 600mg
01/09/2017 PCRU Tasigna 600mg
04/12/2017 PCRU Tasigna 600mg
10/16/2017 PCRU Tasigna 600mg
01/15/2018 PCRU Tasigna 600mg

 

Cancer Sucks!


#6 Buzzm1

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Posted 02 August 2016 - 10:53 PM

Well that is not good. I take Tasigna and have CVS CareMark as my drug plan. Does that mean I have to switch?

I don't think so, but let us know what you hear from CVS, and your oncologist, regarding being grand-fathered in on Tasigna.  The coverage change will be for 2017.  This will be a learning experience for all of us.

 

Healthcare costs are going out of sight and to think, we, being on these $132K/yr.-$156K/yr drugs, are a contributing factor.  I prefer to blame the greed of Big PhRMA.

 

U.S Healthcare Cost (trillions)

2016 3.35
2015 3.2
2014 3.0

2013 2.9
2012 2.8

 

U.S. Spending for Prescription Drugs (in billions)

2015 $425.0  
2014 $373.9
2013 $329.2
2012 $325.8


For the benefit of yourself and others please add your CML history into your Signature

 

02/2010 Gleevec 400mg

2011 Two weakly positives, PCRU, weakly positive

2012 PCRU, PCRU, PCRU, PCRU

2013 PCRU, PCRU, PCRU, weakly positive

2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)

2015 300, 250, 200, 150

2016 100, 50/100, 100, 10/17 TFR

2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000

2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17

 

At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.  

 

In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.  

 

longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation.   GFR and creatinine vastly improved after stopping Gleevec.

 

Cumulative Gleevec dosage estimated at 830 grams

 

Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.  

 

Trey's CML BlogStopping - The OddsStop Studies - Discussion Forum Cessation Study

Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt


#7 r06ue1

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Posted 03 August 2016 - 05:20 AM

But isn't Big Pharma us?  

 

Stock holders demand more> Board elects new CEO to get more> CEO does whatever it takes to get more (including these giant price hikes)> We (people with private insurance, all of us) pay more for drugs> rinse repeat.  

 

Maybe it's just me but the entire system seems to have corruption (in the sense of money being the corrupting factor) built into it.  

 

I was worried this might happen, that the generic form of Imatinib could be pushed by the insurance industry and force people to use it over what they actually need.  If CVS is doing this with Tasigna, other drugs may follow (Sprycel, Bosulif, etc...) and other insurance companies will be forced to follow suit in order to compete.  If one person with CML dies because they were prescribed a medication based on economics and not science, will insurance industry execs be held accountable?  From previous events in US history such as this theoretical one I have outlined, I highly doubt it.  


08/2015 Initial PCR: 66.392%

12/2015 PCR: 1.573%

03/2016 PCR: 0.153%

06/2016 PCR: 0.070%

09/2016 PCR: 0.052%

12/2016 PCR: 0.036%

03/2017 PCR: 0.029%

06/2017 PCR: 0.028%

09/2017 PCR: 0.025%

12/2017 PCR: 0.018%

 

 

Taking Imatinib 400 mg


#8 tiredblood

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Posted 03 August 2016 - 09:57 AM

Well that is not good. I take Tasigna and have CVS CareMark as my drug plan. Does that mean I have to switch?


You and I are in the same boat. I could see us grandfathered in for the first year, then, who knows. It took >4 weeks for me to get prior approval for a different drug I take. It was tough being without the medication that long. Not looking forward to struggling with the insurance company.

#9 Harper3994

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Posted 03 August 2016 - 10:54 AM

I will not be shopping at CVS any longer.

#10 kat73

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Posted 03 August 2016 - 10:58 AM

Wow, this is terrible news.  I'm on Sprycel, but I've always worried about the future fallout for all of us because of the unsustainability of the expense of these drugs.  I could never, never, never go back to Gleevec (or generic imatinib).  It might take care of the CML, but it would be a living death for me, side effects-wise.


Dx July 2009 on routine physical.  WBC 94.  Started Gleevec 400 mg Sept 2009.  MMR at 2yrs.  Side effects (malaise, depression/anxiety, fatigue, nausea, periorbital edema) never improved.  Kidney issues developed because of Gleevec.  Switched to Sprycel 70 mg in Aug 2011.  Above side effects disappeared or improved.  Have been MR3.5 - 4.5 ever since.  Two untreated pleural effusions followed by one treated by stopping Sprycel Jan 2017.  After 9 weeks, PCR showed loss of MMR; re-started Sprycel at 50 mg and in 3 months was back to <0.01% IS.  Pleural effusion returned within a couple of months, same as before (moderate, left side only).  Stopped Sprycel 50 mg for 12 weeks; pleural effusion resolved.  At about a monthoff the drug, PCR was 0.03; at 11 weeks it was 2.06 - lost CCyR? Have returned to 50 mg Sprycel for 3 weeks, intending to reduce to 20 mg going forward.


#11 Antilogical

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Posted 03 August 2016 - 04:32 PM

This is just another step for getting pharma costs under control.  Earlier this year, I had to switch from a very expensive - but effective - non-statin drug that has controlled my cholesterol better than anything else available, due to changes by my drug plan. I expect more drug plans to follow suit with even more drugs targeted, after which we will hopefully see some droppage of drug costs.


Dx: Sudden severe anemia detected 07/2011, followed by WBC spike. CML Dx 02/2012.

Rx: 03/2012-Gleevec400.  Reduced 02/2013 to Gleevec300 due to side effects (low blood counts).

Response: PCR-Und within 7 mo. on G400. Maintained MMR4-MMR4.5 on G300. PCR-Und since 02/2016.


#12 rcase13

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Posted 03 August 2016 - 05:02 PM

Apparently if your already on Tasigna you can stay on Tasigna.

10/01/2014 100% Diagnosis (WBC 278k, Blasts 6%, Spleen extended 20cm)

01/02/2015 0.06% Tasigna 600mg
04/08/2015 0.01% Tasigna 600mg
07/01/2015 0.01% Tasigna 600mg
10/05/2015 0.02% Tasigna 600mg
01/04/2016 0.01% Tasigna 600mg
04/04/2016 PCRU Tasigna 600mg
07/18/2016 PCRU Tasigna 600mg
10/12/2016 PCRU Tasigna 600mg
01/09/2017 PCRU Tasigna 600mg
04/12/2017 PCRU Tasigna 600mg
10/16/2017 PCRU Tasigna 600mg
01/15/2018 PCRU Tasigna 600mg

 

Cancer Sucks!


#13 thatguy

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Posted 03 August 2016 - 07:54 PM

What a heap. So it's a poker game now. I mean, really, I expected this, but on the end of insurance companies. Come on, Novartis, do the right thing...80k or 100k would still be a nice profit each year...
3/25/2015- Dx'ed by FISH : 85% of cells dual-fusion signals, 7% with tri-fusion signals, WBC 212,000. Started Gleevec 400mg.... Calculated .93 SOKAL

08/17/2015- 14.793 % I.S P210 (quest)
10/15/2015- 3.313 % I.S (quest)
12/23/2015- 1.891 % I.S (quest)
1/07/2016- Tasigna 300mg 2x daily
1/14/2016- 4.414 % I.S P210- City Of Hope lab, mutation negative.
1/26/2016- 1.589 % I.S (quest)
2/22/2016- 1.719 % I.S (quest)
2/29/2016- 1.133 % I.S (quest)
3/03/2016- Tasigna 400mg 2x daily.
3/29/2016- 0.663 % I.S (quest)
4/27/2016- 0.781 % I.S (quest)
5/04/2016- 0.652 % I.S.(quest)
5/24/2016- 0.501 % I.S (quest)
6/28/2016-0.534 % I.S (quest)
7/15/2016-0.881 % I.S (quest)
7/22/2016- Bosulif 500mg
7/28/2016- t315i test- Negative
8/22/2016-0.432 % I.S (quest )
11/15/2016-0.325 % I.S (quest)
2/1/2017- .0445% i.s (genoptix)
5/6/2017- .0968% i.s (genoptix)
5/12/2017- .12 % i.s (quest).
6/4/2017- .083% i.s (quest)
6/11/2017- .0295% i.s (genoptix)
8/5/2017- .0501% i.s (genoptix)
11/6/2017- .0270% i.s (genoptix)

#14 Buzzm1

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Posted 05 August 2016 - 08:22 AM

Teva Announces Launch of Generic Gleevec® Tablets in the United States

 

JERUSALEM--(Business Wire)--Teva Pharmaceutical Industries Ltd., (NYSE and TASE:TEVA) today announced the launch of the generic equivalent to Gleevec®1(imatinib mesylate) tablets,100 mg and 400 mg, in the United States for multiple indications approved by the FDA.

 

Imatinib mesylate tablets had annual sales of approximately $2.42 billion in the United States, according to IMS data as of May 2016.

 
 
Note: Teva generic Imatinib in Canada sells for approximately U.S. $6,000/yr.; It will be interesting to find out Teva's pricing here.

For the benefit of yourself and others please add your CML history into your Signature

 

02/2010 Gleevec 400mg

2011 Two weakly positives, PCRU, weakly positive

2012 PCRU, PCRU, PCRU, PCRU

2013 PCRU, PCRU, PCRU, weakly positive

2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)

2015 300, 250, 200, 150

2016 100, 50/100, 100, 10/17 TFR

2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000

2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17

 

At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.  

 

In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.  

 

longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation.   GFR and creatinine vastly improved after stopping Gleevec.

 

Cumulative Gleevec dosage estimated at 830 grams

 

Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.  

 

Trey's CML BlogStopping - The OddsStop Studies - Discussion Forum Cessation Study

Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt


#15 r06ue1

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Posted 05 August 2016 - 10:35 AM

These generics need to come down in price, not that joke of a price drop Sun dropped on America in February.  If the price doesn't come down at least half of what the brand name is, then there is some serious collusion going on behind the scenes and we have a Drug Cartel on our hands.  

 

I feel bad for those on Tasigna, according to Big Insurance, it is the same or "equivalent" to Gleevec.  This is going to be a more common theme moving forward as most insurance companies will adopt the same idea so that they can compete with CVS.  Forcing people onto Imatinib just because it is cheaper does not make it the right drug for the patient.


08/2015 Initial PCR: 66.392%

12/2015 PCR: 1.573%

03/2016 PCR: 0.153%

06/2016 PCR: 0.070%

09/2016 PCR: 0.052%

12/2016 PCR: 0.036%

03/2017 PCR: 0.029%

06/2017 PCR: 0.028%

09/2017 PCR: 0.025%

12/2017 PCR: 0.018%

 

 

Taking Imatinib 400 mg


#16 kat73

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Posted 05 August 2016 - 11:20 AM

And what is their answer to the fact that Tasigna is much, much stronger than Gleevec, and that people who have plateued or not gotten optimal response on Gleevec have their numbers go much lower when they switch to Tasigna?  AND that research is beginning to show that getting people to a deeper response is perhaps going to allow them to try cessation and be successful, thereby not spending the money on a TKI at all someday?  Do the insurance companies realize all this?


Dx July 2009 on routine physical.  WBC 94.  Started Gleevec 400 mg Sept 2009.  MMR at 2yrs.  Side effects (malaise, depression/anxiety, fatigue, nausea, periorbital edema) never improved.  Kidney issues developed because of Gleevec.  Switched to Sprycel 70 mg in Aug 2011.  Above side effects disappeared or improved.  Have been MR3.5 - 4.5 ever since.  Two untreated pleural effusions followed by one treated by stopping Sprycel Jan 2017.  After 9 weeks, PCR showed loss of MMR; re-started Sprycel at 50 mg and in 3 months was back to <0.01% IS.  Pleural effusion returned within a couple of months, same as before (moderate, left side only).  Stopped Sprycel 50 mg for 12 weeks; pleural effusion resolved.  At about a monthoff the drug, PCR was 0.03; at 11 weeks it was 2.06 - lost CCyR? Have returned to 50 mg Sprycel for 3 weeks, intending to reduce to 20 mg going forward.


#17 r06ue1

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Posted 05 August 2016 - 01:26 PM

I don't think there is a line in the accounting books for that Kat.  :(


08/2015 Initial PCR: 66.392%

12/2015 PCR: 1.573%

03/2016 PCR: 0.153%

06/2016 PCR: 0.070%

09/2016 PCR: 0.052%

12/2016 PCR: 0.036%

03/2017 PCR: 0.029%

06/2017 PCR: 0.028%

09/2017 PCR: 0.025%

12/2017 PCR: 0.018%

 

 

Taking Imatinib 400 mg


#18 crob20

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Posted 05 August 2016 - 03:17 PM

It pays to be politically aware. The insurance companies and pharmaceutical companies all need some regulations to keep stupid decisions like this from taking effect.

I wonder what has happened in other countries when access was limited to Gleevec and Sprycel. I thought I read that had happened in UK a while ago.
Diagnosed 3/09 121,000 WBC. Asymptomatic
Imatinib 400 mg started
2/10 PCRU
3/16 still PCRU but side effects worse. Stopped Imatinib for a week. Tried Sprycel 2 days.
4/16 restarted Imatinib at 300 mg.
6/16 showed 1 transcript
9/16 PCRU returned
5/1/17 Imatinib 200 mg
8/17 showed "1 transcript"
10/17 PCRU returned

#19 Gail's

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Posted 06 August 2016 - 02:03 PM

I am curious too, crob20. If pharmacies or insurance companies decline to pay for these drugs, what incentive will there be for pharmaceutical companies to continue their production? Not saying price gouging is ok, just wondering where the pocket book wil interfere with their ethics?
Diagnosed 1/15/15
FISH 92%
BMB 9:22 translocation
1/19/15 began 400 mg gleevec
1/22/15 bcr 37.2 IS
2/6/15 bcr 12.5 IS
3/26/15 bcr 10.3 IS
6/29/15 bcr 7.5 IS
9/24/15 bcr 0.8 IS
1/4/16 bcr 0.3 IS
Started 100 mg dasatinib, mutation analysis negative
4/20/16 bcr 0.03 IS
8/8/16 bcr 0.007 IS
12/6/16 bcr 0.002 IS
Lowered dasatinib to 70 mg
4/10/17 bcr 0.001 IS
Lowered dasatinib to 50 mg
7/5/17 bcr 0.004 IS
8/10/17 bcr 0.001. Stopped TKI in prep for September surgery.
9/10/17 bcr 0.006
10/10/17 bcr 0.088

#20 Buzzm1

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Posted 08 August 2016 - 10:54 PM

Teva and Apotex debut generic Gleevec drugs in the USA http://www.thepharma...rugs-in-the-usa

 

Apotex, another large generic imatinib manufacturer in the Canadian market, has also entered the U.S. market.

 

Looking forward to the pricing competition.


For the benefit of yourself and others please add your CML history into your Signature

 

02/2010 Gleevec 400mg

2011 Two weakly positives, PCRU, weakly positive

2012 PCRU, PCRU, PCRU, PCRU

2013 PCRU, PCRU, PCRU, weakly positive

2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)

2015 300, 250, 200, 150

2016 100, 50/100, 100, 10/17 TFR

2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000

2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17

 

At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.  

 

In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.  

 

longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation.   GFR and creatinine vastly improved after stopping Gleevec.

 

Cumulative Gleevec dosage estimated at 830 grams

 

Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.  

 

Trey's CML BlogStopping - The OddsStop Studies - Discussion Forum Cessation Study

Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt





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