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DiscussionWhat's your experience with Orgovyx (relugolix)?
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Replies to "So everyone on Medicare or Advantage plan is paying $8000 a yr to take Orgovyx? That's..."
Go to your Advantage or Part D web site and find "price your medication" or something similar and you will find out what it will cost you.
Stay Strong Brother
Orgovyx $ 8000 / yr?
Yes and no.
ADT (androgen deprivation therapy) is available in different forms:
Lupron/ Eligard are injectable forms, covered under Part B Medicare, whether Traditional or Advantage plan.
Orgovyx is a pill form covered under an optional/elective Part D Medicare Drug Plan, again whether Traditional or Advantage.
Out of pocket costs to the patient differ.
Using me as an example, I would have paid little to nothing out of pocket for Lupron/Eligard under my Traditional Medicare plus Supplement.
I wanted Orgovyx, which under my Part D drug plan was a 25% patient coinsurance, and my cost was about $ 1,000 / month for 4 months of treatment (I think that I would have moved into a lower out of pocket Plan D stage if I was taking it longer).
There are patient subsidy programs that lower Orgovyx cost based upon income and different Part D plans have different patient coinsurance.
Hope this is helpful.
(and apologies to the forum if I have made any misstatements regarding either pharmaceutical or Medicare coverage)
I started ORGOVYX on April 1st. I am paying $520/Month copay. Not bad compared to $3,000/month with no insurance coverage!
My guess and answers I've seen is not "everyone pays $8k a year. I have TRICARE For Life which also functions as my Part D. a 90 day prescription of Orgovyx runs about $28 co-payment.