Some of my meds, especially the ones with altered dosing, were routinely denied by the insurance company at first try, but were OK'd after bantering back and forth with the Doctor for a couple days. Something to do with formulary and non-formulary drugs and prior authorizations (which I'm not even going to try to decifer on tx). It was somewhat unnerving for me...the wait..the feeling that my life was dependent on their approval. But it all worked out in the end......Pam
Hi Jonney—
If you do get an insurance denial (I haven’t read the whole thread here), here is a clearinghouse of patient assistance programs to draw from. Just go to ‘brand names’, then scroll down to Procrit. This site can help you access thousands of other patient assistance programs in the future too; pretty cool site:
http://www.needymeds.org/index.shtml
Bill
Procrit is yet another shot and it is very very expensive (a box of ten shots is about $6,000) but it works fantastically. Sometimes you have to fight with the insurance company a little (mine would only give me the generic epogen version and it was a pain to fight for that but the local pharm folks really helped me). But this was years ago and maybe it wasn't as common.
I do know that Procrit has it's own patients assistance plan if your insurance doesn't cover it and you can contact them directly.
It takes from 2 - 6 weeks to work (usually in about 2/3 for most) and once it does it should keep your hemo up in the 10s which is just fine as you can imagine where you are now. Sometimes you have to figure out the dosages (2x a week was too much for me 1x not enough every 5 days at 40,000 was fine) so it's best to get started ASAP.
Put a call in and say hey doc help me out get your med team working on this for me please! They should have a staff that knows it's way around medical insurance and be the ones to be proactive for you right now.
7.9 is BOGUS! Drop meds, get transfusions bwah - get the procrit boy it will save your course of treatment like it did mine. I was on it for 69 weeks and would NOT have made it without it!!!!!!!!!!
Your insurance might cover it, you need to check with them. Many employee coverage plans have several aspects like prescription coverage, medical coverage (for stuff like dr visits and labs) and possibly separate coverage for hospital (and same-day surgery type aspects). I found that my prescription coverage was less robust for stuff like Procrit, Neupogen and even Pegasys. When I needed procrit-like stuff I went to see a hematologist. Since they administed the stuff in the office (not a prescription that was self-injected) the coverage under the medical aspects of the policy (not the prescription part) it was cheaper for me from a co-pay point of view. Sometimes you need to work the angles a little bit to find the best and cheapest alternatives you can find. Usually, it just takes persistence and some phone time.
yes i don't get it my insurance will cover it???
Wow, 7.9 hgb...I'm surprised you are still ambulatory! I started on Procrit 2 weeks ago today (will be doing my 3rd shot tonite) and my energy came back in a big way last Friday. What a difference it makes! Night and day...........
Hope they'll approve it for you...Hope you feel better soon! Pam
I had this problem and by the time Procrit was Rx'd, it took several weeks before I could function without feeling like I was going to pass out. It is an injection.
no am not on a trial, she was going to send me to mcv in richmond a few weeks ago? can i get the procrit at any pharmacy and is it in pill form?
thank you for responding i am at week 27
Jonney what week tx are you on (sorry I can't even remember these things).
if you mean your hemo yes that is very very low. Rather than stop Your meds and hurt your chances of SVR have you asked her to prescribe procrit and get the reds up that way? If you've been having this problem for so long why won't she try and tackle it this way - are you on a trial?
If you do have a viral breakthrough it won't be extension it will be retreating. If you continue to test negative you will just finish at 48 one has nothing to do with the other.
A whole bunch of us understand how you feel and it's one of the worst feelings in the entire world. You HAVE to stop doing things like cleaning your room for a little while just make do with as little as possible.
And be careful on STAIRS and don't drive if you dnt' have to (i remember just turning my head to the left or right to look behind me would make me feel faint) oh yes and be careful in the shower.....thats where I fainted and thank God grabbed the curtain on the way down......it's easy to faint when you are this low so BE CAREFUL.