Xalkori Cost On Medicare--mexico, Cananda, Anything???

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My mom was diagnosed with stage IV NSCLC with only BM two weeks ago. The day before she was to get her port for Carbo/Taxol (which Medicare had pre-approved), the called and said her ALK came back positive so new plan is Xalkori. She went to get the med and the price is astronomical. She is on Medicare and there is absolutely no way that she can afford the drug, and no way even spread between the three kids we can make it work. Has anyone obtained the drug in Canada or Mexico? We're willing to do anything legal to get this for her. She got a grant that will cover two month of it, but after that we just don't know what to do.

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1

Is your mom low income? If she is, she might qualify for help paying her Medicare co/pay and other Medicare expenses. I have put a link below. She can also contact the pharmaceutical company and see if she qualifies for Financial Assistance. I have also put a link below for that info.

Medicare Savings Programs-
medicare.gov/your-medicare-costs/help-paying-costs/medicare-savings-program/medicare-savings-programs.html

Xalkori Financial Assistance-
xalkori.com/getting-xalkori

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2

Thanks BL. Not low income or at least enought to qualify as such. We tried the maufacturer but because they are on Medicare they cannot help, illegal for pharmacies to use coupons towards a Medicare prescription. Found out yesterday the onco has grants to help, which at least will get her several months of copay taken care of, bit long term is a concern. Will keep researching.

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3

I'm glad she was able to find some help. Often drs can suggest resources when a patient can't pay for a drug.

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4

I wonder as a possible long term solution, whether or not a pharmacy coupon could be used in place of Medicare coverage, depending on which one provides the greater benefit for that specific transaction?

The card MedsChat offers says it can save patients an average of 15-75% off: Rx Savings Card

I realize that pharmacy coupons aren't intended to act as a replacement for insurance, but whether that's the case or not, the opportunity for such a big savings may still be worth looking into if there are any loop holes in their policies.

In order to even get a price quote with the card it may be that you have to say you don't have insurance and only want to use a savings card for this purchase... I always support being completely honest but fear that they might turn you away without making any exceptions to their policies at the first mention of Medicare. -Though I'd like to be wrong about that.

Just wanted to offer another idea to the mix. I hope your mom is doing well at the moment!

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5

David, there are certain rules when it comes to discount prescription cards and coupons when Medicare is involved.

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6

Thank you for your clarification BL, I am aware of such rules - which is why I suggested not even mentioning the presence of insurance/medicare from the start.

Unless every single pharmacy [mom & pop shops included] has a database showing that you do have insurance, I don't see why this wouldn't work?

Usually when I go to the pharmacy for a prescription I'm asked whether or not I have insurance (medicare/medicaid/etc)... I just haven't had any reason to believe that pharmacies know this information ahead of time; especially a small chain one that a patient has never been to; but this is just my experience.

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7

David, I understand what you're saying. It is never a good idea to lie. So many things are cross referenced now in data bases and it could come back to haunt you on down the road. Also if a state expanded Medicaid, it would be unusual for someone to not have insurance.

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8

Have to keep in mIndia this is a level/class 5 drug and even in a major metro cit where we live, has to be ordered from a specialty pharmacy so you can't just wall in anywhere and get it, and most pharmacies won't even have access to it without special handling.

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9

I totally agree with your points BL & AngryandSad. As opposed to lieing, my philosphy was that just because you have insurance doesn't mean you have to use it, much like a tool kit if you will... Either way it's a real shame that drug companies are making this so inaccessible... I think the idea of visiting another country for affordable healthcare is always growing in popularity, seeing how most medications are a fraction of the price than in the States. Sorry I couldn't have been of more help!

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10

It is also outrageously expensive in Europe. Medicare is a fickle thing. By law you cannot give anything with more than $5 value to a Medicare recipient or there are nasty consequences.

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