Jump to content


Photo

Anybody getting Medicare part D from ExpressScripts


  • Please log in to reply
4 replies to this topic

#1 Dom

Dom

    Advanced Member

  • Members
  • PipPipPip
  • 186 posts
  • LocationNew Jersey

Posted 22 February 2017 - 07:22 PM

I have to get on Medicare part D by March 1st. Using the Medicare site, there seems to a wide range of choices. Some have an "expected annual expense" of $10,000 and one, ExpressScripts, has an expected annual cost of only $6,000, which is actually less than my current cobra. Hmmmmm, I think to myself, I must be paying a hidden price somewhere else.

Dos anybody have experience with ExpressScripts as a Medicare part D provider?

Diagnosed in February 2014. Started Imatinib 400 in April.
2014:     3.18     0.91
2015:     0.22     0.16     0.04     0.55
2016:     0.71     0.66

(Started Imatinib 600 in April 2016)
2016:     0.42     0.13     0.45
2017:     0.17     0.06     0.10     0.06     0.34


#2 Buzzm1

Buzzm1

    Advanced Member

  • Members
  • PipPipPip
  • 972 posts
  • LocationSilicon Valley

Posted 22 February 2017 - 07:36 PM

Dom, shweflen is  http://community.lls...rycel/?p=194778

http://community.lls...rycel/?p=194791


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 shweflen

shweflen

    Advanced Member

  • Members
  • PipPipPip
  • 51 posts
  • LocationAnderson, IN

Posted 22 February 2017 - 09:02 PM

Dom,  I switched from Humana to ExpressScripts on January 1 in order to be able to get the generic imatinib.  I paid $698 for the first months supply, 90 - 100 mg pills.  The post on the link Buzzm1 provided you show what I think the rest of the year is supposed to look like.  I will post my costs as I go along, which won't be much help if you have to decide by March 1.  I should get the next month's supply in the next 4 or 5 days and will post the cost as soon as I know what it is.  So far, the Medicare Plan Finder has been closer than anyone else's estimates.


10/20/2016 BCR-ABL:ABL = 81.622

01/11/2017 BCR-ABL:ABL =   8.028

04/12/2017 BCR-ABL:ABL =   0.157

07/07/2017 BCR-ABL:ABL =   0.000

10/04/2017 BCR-ABL:ABL =   0.041

11/28/2017 BCR-ABL:ABL =   0.000

 

 


#4 Dom

Dom

    Advanced Member

  • Members
  • PipPipPip
  • 186 posts
  • LocationNew Jersey

Posted 22 February 2017 - 10:00 PM

Thanks to buzz and shweflen for the info. I think I'm taking the plunge and going with ExpressScripts. According to the plan finder, I'm paying 1,230 in March (37.50 premium plus 400 deductible plus 25% of what remains) then 1,841 in April (can't calculate why, but that's the first month of the gap) then 1,725 in May (ditto the last parenthesis) then 238 every month after that. So it's 6,462 in my first year, and I suppose 6938 the next year. Really not bad. My cobra was 6,600 in premiums and no co-pay for imatinib, so Medicare isn't bad.

Now to move out of jersey. I pay 7,000 in real estate taxes here.

Diagnosed in February 2014. Started Imatinib 400 in April.
2014:     3.18     0.91
2015:     0.22     0.16     0.04     0.55
2016:     0.71     0.66

(Started Imatinib 600 in April 2016)
2016:     0.42     0.13     0.45
2017:     0.17     0.06     0.10     0.06     0.34


#5 Buzzm1

Buzzm1

    Advanced Member

  • Members
  • PipPipPip
  • 972 posts
  • LocationSilicon Valley

Posted 23 February 2017 - 03:49 PM

Dom, after you complete your first transaction, please post the details of it, and ensuing transactions, on the following thread so that all Medicare users may benefit from the knowledge to be gained ... thanks in advance 

 

http://community.lls...rycel/?p=194772


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





1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users