Due to an outdated insurance benefit design, cancer patients across the country are not able to afford their oral anticancer medications. Please take a moment to hear from the patients themselves, and learn about what we are doing to find a solution.
If unequal reimbursement has affected you or someone you know, please write a few sentences that tell a personal story. You should include information such as status regarding your cancer (age, when diagnosed, health today, treatment needs). If you are writing about someone else, please use only their first name and their relationship to you.
Also be sure to include your experience such as: I did not get the care I need because insurance reimbursed more for a different treatment; I have gone into debt to pay for what insurance doesn’t cover; my treatment was delayed waiting for coverage to kick in.
I am 71 years old. Diagnosed in 2009 with Multiple Myeloma. Anyone over 65 is eliminated from the Oral Parity Act because Medicare does not approve or recognize it. So anyone over 65 does not get this benefit. 65 year olds are where most of the cancer patients are and where the least $$$ are with most on only SS and not much else. I am medicare and because I was in the catastrophic area I only had to pay 5% of my bills. but when I have to base this 5% charge on an oral med called Pomalidomide which sells for around $14,000 for 21 pills my 5% is around $630+ per month. Very steep for us.
patient from Stillwater
While undergoing chemo therapy for multiple myeloma four years ago, I was additionally being medicated with Revlimid 20mg daily on a 14 day cycle. My ‘copay’ was almost $700. My average cost (copay) per month was $1,013. Only because I had very good insurance at the time and had saved for years that this expense was even possible.
patient from Braunfelts,TX
I was diagnosed at 49 with MM. I am now 60. Forced by the disease to retire early, I filed for Social Security Disability. With the new deductions, my monthly check for 2016 will be $1,789. I have Humana Choice Medicare Health Plan with Prescription Drug Coverage. My copay for 14 days of Pomalyst for January was $2,931.78. Fortunately, my husband is able to support me.
patient from Cincinnati, OH
Seven years ago I was diagnosed with multiple myeloma. I was prescribed Thalidomide. Because it was an oral chemotherapy, it was considered a prescription. My prescription coverage at the time only covered 50% of the cost. My husband and I had to pay over $4,000 per month out of pocket. As you can imagine, this was a hardship. We spent a large portion of our savings that we were saving for our daughter’s college education. We did this for 6 months. Currently, I take Revlimid, and it is covered because we have different insurance provider now. My husband works for the US government, and I am a public school teacher.