Neulasta vs Neupogen (sp?)- Insurance issues!!

Artista928

So my insurance isn't auth'g neulasta because my onc will have me on chemo every 3 weeks instead of every 2. There is no evidence that says every 2 weeks is more effective than 3 so because I'm alone and with those side effects, she's putting me on every 3 weeks to give me more good days before being zapped again.

I told her to change it to every 2 weeks in her notes to get it auth'd and then when 2 weeks is about up to say side effects bad and need another week---if they keep asking for an auth before each time. That I don't know. So she said good idea and has an idea.

Otherwise for those of you who didn't get neulasta auth'd, did they do neupogen? I guess it's the same thing? I see some do this and some do neulasta for the increase wbc counts. Or if not, what did you do?? I have an infection as it is and dumb ass insurance co thinks it'll cost them less to keep me out of the hospital for infection control than to let me have these shots. rollstheyes...

doxie

Have you filed an appeal to the ins co? It seems that even though delaying until your infection is cleared up is an option, but not a good one because it looks like your chemo has been delayed.

Neupogen certainly is another option to check on.

I had TC each 3 weeks and still got a Neulasta shot, except for the last round. I had a serious allergic reaction to it. It was good I managed 3 shots because after the 4th round I barely escaped the hospital and had a WBC so low I had to wear a surgical mask. My next round would have had to be delayed.

So even those of us on TC over 3 weeks often need one of these drugs to continue.

Artista928

MO is going to adjust her note in an attempt to get it approved. The infection is under control enough that I was going to start chemo on Mon since I am on oral abx now until I'm done with chemo at least. The insur co is being picky about my tx plan being every 3 weeks rather than 2. They are essentially deciding it for me by not approving this potentially life saving thing because they have it down that you have to be receiving tx every 2 weeks. Who made them oncologists??? If I don't get this and I wind up in bad shape, I'm going to blast their asses. I'm Iranian and we have tempers that blow people's socks off. It's simply maddening! :X

Artista928

Got it approved, finally! She put me on the every 2 week chemo sched but the day before 2nd infusion, I see her and if I'm not up to it, she'll give me another week saying SE issues. Once it's approved, it is for the course of chemo so if she says I'm not doing well on the every 2 week zap then they can't say no Neulesta then once they approved it.

MelanieBC

What is the real difference between Neulasta and Neupogen? As far as I can tell they are the same medication, but the course of treatment is longer with Neupogen, is this right? My mom has to do Neupogen because her insurance doesn't cover Neulasta and quite frankly can't afford $18,000.00 for the 6 treatments of it.

HappyHammer

Artista- sorry you are having to deal with ins issues along with the BC and infection. Enough is enough, right? Glad is sounds like Neulasta has been approved. (I called it NeuBLASTA the whole time getting it since it's supposed to blast up the count Anyway, took injection in arm first 4 times but it hurt sooo, tried having it done in stomach last 2 times....so much more comfortable IMO. Just wanted to suggest that if you haven't tried it. Sounds terrible but was good- wish I had been brave enough to try it earlier.

Take good care!

Artista928

^^ Thanks for the tip! xo

Shopgal2

Ariista see if you can get the neulesta on body injector. It avoids a repeat trip to the treatment center to get the shot.

SpecialK

Melanie - Neulasta has to be given within a specific time period after the chemo infusion and can't be given again until two weeks have passed, whereas Neupogen - essentially a drug that does the same thing as Neulasta, both are colony stimulating factors that increase your WBC - can be given further out from the chemo infusion and closer to the next infusion.  Those getting weekly infusions, like Taxol, can't have Neulasta, but can have Neupogen  Here is a link that explains both:

http://breastcancer.about.com/od/lifeduringtreatment/f/neulasta_cost.htm

Some oncologists give Neulasta or Neupogen as part of their protocol, others wait and see how their patients do and whether there is a need for either.  Both of these injections have potential side effects so if they are not needed it avoids an extra expense, and potential additional unpleasant side effects.

aquamarine77

If you will be getting Neulasta, BE SURE TO ASK YOUR CLINIC ABOUT GRANTS OR HELP PAYING FOR NEULASTA before you begin it. I didn't get any insurance statements until just after my 4th & final Neulasta shot, only to find out my share was $1300+ a pop. And, then, on my next visit they called me into the business office to inform me that a grant could have paid for it, but that it was NOT RETROACTIVE. The grant was not tied to income and would have paid over $5000. I had no way to know that I should ask.