Ibrance for Patients on Medicare

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lrsreyes
lrsreyes Member Posts: 93
edited August 2019 in Stage IV/Metastatic Breast Cancer ONLY

I just received a call from CVS and I was asked information on my Medicare RX to check if Ibrance will be covered. I am worried because I have mets on bones and pancreas. What should I do if Ibrance is not covered?



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  • Anonymous
    Anonymous Member Posts: 1,376
    edited August 2019

    Hi there, I am not on Medicare but here is an explanation from GoodRx.com. It will depend on your Part D plan.

    https://www.goodrx.com/ibrance/medicare-coverage


    If you still have a large co-pay you can seek co-pay assistance from Pfizer

    https://www.pfizeroncologytogether.com/patient/financial-assistance#government-insured


    Maybe others who are on Medicare and Ibrance can tell you more. Best of luck with this!

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  • Spookiesmom
    Spookiesmom Member Posts: 9,568
    edited August 2019

    Get in touch with your MOs office. Mine knows how to access financial aid, it it a very expensive med. Pfizer also can help. But contact MO!!!

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  • BevJen
    BevJen Member Posts: 2,523
    edited August 2019

    I use Express Scripts for my Part D Medicare prescription plan. I had to have pre approval for Ibrance for them to cover it, and the MO had to send in some information to make that happen. After that, the drug was "covered" -- I am using quotes because the co-pay amounts are astronomical under Medicare Part D. Help is available (look back at the Ibrance thread and you will see lots of information provided by Jaycee there) but all of the assistance programs are income based so far as I can figure out. There are a number of private organizations (partially funded by the drug companies, interestingly) and they provide varying amounts of help. On the Pfizer website, there are links to some of these. I believe that Pfizer sometimes also provides the drug under compassionate care, but those are limited situations.

    I'm with Spookiesmom who said to contact your MO's office. They should have someone there who can help you wade through all of this.

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  • gb2115
    gb2115 Member Posts: 1,894
    edited August 2019

    There are assistance programs. I know someone who gets it for free who is not low income.

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  • lrsreyes
    lrsreyes Member Posts: 93
    edited August 2019

    Thanks for all your posts. I have already contacted my MO office for help and am waiting for her reply.


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