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Medicare Drug Approval

Forums General Melanoma Community Medicare Drug Approval

  • Post
    Charlie S
    Participant

      Here is a link to an article that might offer some insight into what possibly lies ahead for Medicare to approve Yervoy.

      Though the article is about Provenge, a Prostate cancer drug, the similarities are striking when comparing to Yervoy.

      Provenge is an immunotherapy as is Yervoy.

      Provenge extended overall  survival about 4 months in trials, about the same as Yervoy

      Both are pricey: Provnege is 93K, Yervoy (at least now) 120K.

      Here is a link to an article that might offer some insight into what possibly lies ahead for Medicare to approve Yervoy.

      Though the article is about Provenge, a Prostate cancer drug, the similarities are striking when comparing to Yervoy.

      Provenge is an immunotherapy as is Yervoy.

      Provenge extended overall  survival about 4 months in trials, about the same as Yervoy

      Both are pricey: Provnege is 93K, Yervoy (at least now) 120K.

      The troubling part is that Provenge was FDA approved in April of 2010 and it will still be another 90 days, following public input, before Medicare gives final approval to pay for Provenge.  Lets hope it doesn't take another 15 months for Yervoy.

      Anyway, here is the article:

      http://www.charlotteobserver.com/2011/03/30/2183972/medicare-to-pay-for-93000-prostate.html

      Cheers,

      Charlie S

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    • Replies
        jag
        Participant

          Thanks Charlie.  That is good to know-should anybody need it.

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          jag
          Participant

            Thanks Charlie.  That is good to know-should anybody need it.

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            chet
            Participant

              $120,000?! Wow, this just made me sick to my stomach. I'm still under my mother's insurance but will be dropped on September 25 when I turn 26 I believe. A lot of that insurance is going towards my IL-2 right now. Does anyone know how soon they'll let people start going on Yervoy???

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                Charlie S
                Participant

                  To put things in perspective Chet, Aldesleukin (IL-2) is about 8K per infusion,,,,,,,,,,,so if you get one every 8 hours, that is 24K per day for the drug alone.  If being received in ICU add another 10K per day,

                  Prior to receiving IL-2, there was a cardiac stress test, pulmonary lung function test and blood gas, plus a brain MRI and PET/CT Overlay Scan.

                  So, here is the true cost breakdown of my IL-2 costs through 2 cycles rounded down from my actual itemized hospital billing.

                  Pre IL-2 Scans………18K

                  Screening………………7K

                  38 Bags IL-2…………304K

                  ICU/Hospital……………120K

                  Other…………………….27K

                  Post IL-2 Scans…..30K( two scans for two cycles without the Brain MRI)

                  ________________

                  Total for two cycles of IL-2= $542,000

                  That is over one half of a million dollars…………my Medicare is 80/20, so I only owe just a tick over $108K in co-pays; which by my calculations, at  500 dollars a month will take 216 months to pay.

                  Oh wait,,,,,,,,,,,I forgot I haven't finished paying the co-pays on the $154K on the Intron and, crap, the ten surgeries at 30K each, I forgot about that 300K, oh, shit, then I did some IL-7 and 11…………..oh well, forget about being a bionic man, I'm a Millionaire Man !!!!!!!!!!!!!!!!!!!!!!!!!!

                  I'm surely no defender of pharma, but it is important that people know just how much existing treatments actually cost before getting too worked up about future treatment cost.

                  And yes, beyond the treatment, it makes me puke too !

                  Cheers,

                  Charlie S

                  (spare a dime buddy?  chuckle)

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                  MRFUser2011
                  Participant

                    Charlie, I am curious how it is that you continue to get treatment (obviously owing a lot from previous treatment still)? I am fairly new to the melanoma treatment experience so have only had experience with two surgeries.  I am just wondering what happens if you already owe for previous bills and need more treatment how it is handled?

                    Blessings, Shari

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                    Jerry from Cape Cod
                    Participant

                      Shari,

                      Our medical system will not refuse treatment over outstanding charges just for instances like this and hundreds of thousands very similar

                      Jerry from Cape Cod

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                      Jerry from Cape Cod
                      Participant

                        Shari,

                        Our medical system will not refuse treatment over outstanding charges just for instances like this and hundreds of thousands very similar

                        Jerry from Cape Cod

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                        MRFUser2011
                        Participant

                          Charlie, I am curious how it is that you continue to get treatment (obviously owing a lot from previous treatment still)? I am fairly new to the melanoma treatment experience so have only had experience with two surgeries.  I am just wondering what happens if you already owe for previous bills and need more treatment how it is handled?

                          Blessings, Shari

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                          Charlie S
                          Participant

                            To put things in perspective Chet, Aldesleukin (IL-2) is about 8K per infusion,,,,,,,,,,,so if you get one every 8 hours, that is 24K per day for the drug alone.  If being received in ICU add another 10K per day,

                            Prior to receiving IL-2, there was a cardiac stress test, pulmonary lung function test and blood gas, plus a brain MRI and PET/CT Overlay Scan.

                            So, here is the true cost breakdown of my IL-2 costs through 2 cycles rounded down from my actual itemized hospital billing.

                            Pre IL-2 Scans………18K

                            Screening………………7K

                            38 Bags IL-2…………304K

                            ICU/Hospital……………120K

                            Other…………………….27K

                            Post IL-2 Scans…..30K( two scans for two cycles without the Brain MRI)

                            ________________

                            Total for two cycles of IL-2= $542,000

                            That is over one half of a million dollars…………my Medicare is 80/20, so I only owe just a tick over $108K in co-pays; which by my calculations, at  500 dollars a month will take 216 months to pay.

                            Oh wait,,,,,,,,,,,I forgot I haven't finished paying the co-pays on the $154K on the Intron and, crap, the ten surgeries at 30K each, I forgot about that 300K, oh, shit, then I did some IL-7 and 11…………..oh well, forget about being a bionic man, I'm a Millionaire Man !!!!!!!!!!!!!!!!!!!!!!!!!!

                            I'm surely no defender of pharma, but it is important that people know just how much existing treatments actually cost before getting too worked up about future treatment cost.

                            And yes, beyond the treatment, it makes me puke too !

                            Cheers,

                            Charlie S

                            (spare a dime buddy?  chuckle)

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                          chet
                          Participant

                            $120,000?! Wow, this just made me sick to my stomach. I'm still under my mother's insurance but will be dropped on September 25 when I turn 26 I believe. A lot of that insurance is going towards my IL-2 right now. Does anyone know how soon they'll let people start going on Yervoy???

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                            ADSCLT
                            Participant

                              Hi Charlie,

                              I am in Charlotte, NC and my father has Melanoma, stage 4.  I was told you know every doctor in NC and wanted to ask your advice.  We go to Carolina's Medical Center too.  He was diagnosed with Brain Mets two weeks ago and will finish WBR tomorrow.  We are seeing Doctor Amin tomorrow afternoon and wanted to see if you had any advice to treatments available and on the doctors.  This will be our first meeting with Amin.   If you could email me at [email protected]  I would greatly appreciate it.   Thank you!

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                              ADSCLT
                              Participant

                                Hi Charlie,

                                I am in Charlotte, NC and my father has Melanoma, stage 4.  I was told you know every doctor in NC and wanted to ask your advice.  We go to Carolina's Medical Center too.  He was diagnosed with Brain Mets two weeks ago and will finish WBR tomorrow.  We are seeing Doctor Amin tomorrow afternoon and wanted to see if you had any advice to treatments available and on the doctors.  This will be our first meeting with Amin.   If you could email me at [email protected]  I would greatly appreciate it.   Thank you!

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