How Do I Get Ibrance Costs Paid on Medicare?

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DivineMrsM
DivineMrsM Member Posts: 9,620
edited March 2019 in Stage IV/Metastatic Breast Cancer ONLY

I’ve discussed this matter on the Ibrance thread and would appreciate any further input.

The cost of Ibrance is staggering. If you have private insurance, insurance through your employer, the Pfizer Company had a co-pay card that picks up the cost. You end up paying zero.

* Not the case for those on Medicare! My insurance situation may be changing to where I may be going on Medicare and what I’m reading scares me! Stories of monthly co-pays of over two thousand dollars! The Pfizer Company doesn’t assist those on Medicare. Really, financial ruin scares me a hell of a lot more than progressive metasteses which is scary enough on its own!

If you are on Medicare and you are taking Ibrance, please share your insight on how to get this medicine paid for without breaking the bank. It seems unfair that Medicare recipients must shoulder so much of the cost while those with private insurance receive financial help.


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  • 50sgirl
    50sgirl Member Posts: 2,527
    edited March 2019

    Divine, There is assistance available even if you are on Medicare. It has been a while since I took Ibrance, and I do not remember the organization who provided assistance. What I can tell you is that my oncologist’s office handled everything. I did not have to do a thing. As soon as I was prescribed Ibrance, the office automatically worked to find assistance. Have you asked about it at your cancer center? Some specialty pharmacies will also help find assistance. Most assistance organizations have an annual income cap of $100,000, and that includes any amount withdrawn from 401k and IRA, but many Medicare recipients have the entire copay covered. Without that assistance, if you have Medicate D, you might have to pay $2000 the first month and maybe $500 -$600 after that. It adds up quickly.

    I will try to look and find the names of organizations providing help, just in case your cancer center cannot help, but I wanted to give you the limited info I have provided Hereford now.

    Hugs and prayers from, Lynne


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  • 50sgirl
    50sgirl Member Posts: 2,527
    edited March 2019

    Divine, I noticed that PfizerOncologyTogether.com mentions that they will help find financial asstance to Medicare recipients. It says to call 1-877-744-5675. It specifically states that they help find assistance for people enrolled in Medicare.

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  • DivineMrsM
    DivineMrsM Member Posts: 9,620
    edited March 2019

    Lynne, thank you for your reply and the information. I'm scheduled to go to an informational meeting about Ibrance at the cancer center on Monday and I will ask about how they can help me get help paying for the medicine should I pick up Medicare, and whether the center has some type of financial navigator to help figure it out, how other patients manage the financial part of it.

    Because I've been dealing with metastatic breast cancer since the beginning of 2011, I've also been dealing with extensive medical co-pays of thousands and thousands of dollars in these 8+ years. I feel fortunate—as fortunate as a person with mbc can feel—that I've had a good response to treatment, but the thought of even higher costs going forward is a little soul-crushing.

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  • 50sgirl
    50sgirl Member Posts: 2,527
    edited March 2019

    http://www.medicarerights.org/fliers/Help-With-Drug-Costs/copay_charities.pdf?nrd=1

    See if this link works and links to table.

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  • DivineMrsM
    DivineMrsM Member Posts: 9,620
    edited March 2019

    Thanks, Lynne! I will bookmark the links!


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  • 50sgirl
    50sgirl Member Posts: 2,527
    edited March 2019

    Here is another resource. If link doesn’t work, let me know

    https://www.pparx.org/prescription_assistance_programs/medicare_drug_coverage



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  • 50sgirl
    50sgirl Member Posts: 2,527
    edited March 2019

    It is shameful that people have to spend so much money to stay alive. I know there have been discussions about it on the boards, but no one should have to risk their financial stability to pay for healthcare or medications. I remember when my father was in his 80s and quite ill. I used to pick up his prescriptions and not tell him about the ridiculous copays I had covered for him. At the time my dh and I had jobs that allowed me to help out my dad, but he would not have been happy to learn about my little secret. He was a proud man who had worked very hard.

    The newer drugs are definitely helping people live longer and/or better lives, but the costs are way out of the range that most people can comfortably afford. It is easy to understand why some sick and elderly people declare bankruptcy or fall into poverty when one serious illness strikes.

    Okay. I will leave my soapbox now. I do hope you find asdistance. Organizations do run out of money, but they seem to have available funds open up again.

    Hugs and prayers from, Lynne


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  • DivineMrsM
    DivineMrsM Member Posts: 9,620
    edited March 2019

    Lynne, your dad didn't realize it, but he had a certain kind of insurance to help him: you! In that way, he was fortunate and I'm sure he realized it, even if he didn't know of your financial assistance. How good of you to help him.

    I get the part about him being a proud man who worked hard. My husband and I have been responsible people all our adult lives, paying bills on time, live within our means, don't believe in credit card debt, have some emergency funds, etc. To think of doing all the right things you know how to prepare for emergencies and then learn it might not be good enough can boggle the mind.


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