Should I pay for Zometa myself?

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Christine2000
Christine2000 Member Posts: 176
edited June 2014 in Stage III Breast Cancer
hey all--saw my oncologist today-- I JUST finished treatment, 5 months of chemo, double MX and 6 weeks of rads that ended friday. Started tamoxifen on halloween! My onc did NOT bring up zometa but I did--she hemmed and hawed and then said my bone density was very good which meant insurance wouldn't pay for it. She went on to say I should take it. Trying to decide if I should pay for it myself! 
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  • lkc
    lkc Member Posts: 1,203
    edited December 2009

    Christine. I am a huge advocate on Bispsphonates; not only do they reduce recurrences to Bone, but also have a prophlactive effect on ALL mets.

    PLEASE google it & do your research.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2009

    My Onc is very pro Zometa.  He just attended a conferance on the positive Zometa research.

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  • Christine2000
    Christine2000 Member Posts: 176
    edited December 2009

    I WANT to take it! I am distressed that it will cost me 6K a year!!! 

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  • Pure
    Pure Member Posts: 1,796
    edited December 2009

    I was told that if your doc fights for it you will get it.  She should atleast try!!!!!

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  • golfer779
    golfer779 Member Posts: 1,378
    edited December 2009

    I would definitely push the issue with your doc to push this through your insurance co .... your taking Tamoxifan as a preventative measure right ????   What's the difference between that and Zometa ????

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2009

    ? WHy $6K a year? You would probably only get it twice a year at about $600 a dose.  (the zometa thread had a discussion of costs).  Look at the breaking news on bco from SABCS.  It certainly seems worth it to me.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2009

    Get a second opinion.

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  • Gitane
    Gitane Member Posts: 1,885
    edited December 2009

    I think Zometa is going to help us.  My oncologist brought it up, not me, and he said I should pay for it (he mentioned $600) if for some reason my insurance refused.  Fortunately, my insurance is paying for it.  Don't give up if you want this treatment.

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  • KerryMac
    KerryMac Member Posts: 3,529
    edited December 2009

    At least try and get it paid for by insurance. You can try the "preventative of osteopenia" route, I know that has worked for others.

    My Onc said it wasn't worth paying for it, if my insurance declined it (they didn't) and that an oral bisphosphonate would work just as well - and is a lot cheaper. So there is that option. I personally would have still gone with the Zometa and paid out of pocket. For me, in Canada, it costs $600, including infusion....maybe you need a trip North...???

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  • Christine2000
    Christine2000 Member Posts: 176
    edited December 2009

    Okay-- I emailed with my oncology nurse who says it will cost about 1K per infusion. I can live with that. I'll start this spring, just to give my body a chance to heal from chemo and rads. Kerry, BELIEVE ME--the effect this disease is having on my pocket book (and I have "good" insurance!) a trip up north sounds pretty dang good!

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  • KerryMac
    KerryMac Member Posts: 3,529
    edited December 2009

    Well, we have a spare bed if you ever do!!

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2009

    You can also appeal to your insurance company.  Sometimes they just like to play with your money just by denying coverage a few times. Put a formal letter in and also ask your onc to pressure for this treatment.

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  • hrf
    hrf Member Posts: 3,225
    edited December 2009

    I'm in Canada and my extended health care wouldn't pay for it. Access Zometa has been set up to help people get the drug because most don't have coverage. Access Zometa paid for the nurse to come to my house to administer the drug and they also helped by subsidizing part of the cost of the drug. I paid personally for the rest of it.

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  • crusader1
    crusader1 Member Posts: 1,222
    edited December 2009

    Christine,

    I also live in NY. Westchester County...My onco prescribed Zometa after my chemo for just bone loss no mets. I had to do many inquires with my insurance and finally I found out it was covered by my health insurance..GHI and not by my prescription insurance. Real strange. Try to keep pursuing the coverage. It can't hurt to take it. Yes the recnet San Antonio conference praised  taking biophosphates..that is what Zometa is.

    Hugs,

    Francine

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  • robyn33
    robyn33 Member Posts: 99
    edited December 2009

    I think trying the "preventive for osteopenia" is the way that I was able to get Zometa covered through my insurance.  It was odd, though, that they would ONLY cover the drug if it was given intraveneously, as opposed to a pill prescription.  Okaaaaay....  Hook me up!!!!  :-)

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