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Well, I'm not a fan of physicians who do not believe in shared decision making.

Did she explain why, go over alternatives, look into insurance...

Orgovyx does have some advantages over what she prescribed for you and others.


Lower CV side effect profile
No flare
Faster castration
Higher sustained castration while on it
Faster recovery of T once stopped.

May be expensive
Requires patient discipline to take each and every day.

Did she describe a time you would be on ADT, 6, 12, 18, 24 months, indefinite...?

I did Lupron my first time, 18 months, 90 day shots.

This time around when my medical team suggested Lupron, I said no, Orgovyx for the reasons I listed and my CV history. Financial toxicity is not an issue for me with TRICARE For Life as my Part D.

So, prescribing Orgovyx may be an insurance issue, since it's expensive, they may deny for "cheaper" drugs that achieve the same outcomes. If so, and you have CV issues, that may be the basis for appeal.

If it is the bull headedness of your physician, well, that's a different story, especially since you say alternatives are limited.

Maybe lay out the reasons you want Orgovyx, see if she actively listens. This is just a possibility but not out of the realm of the possible, with Orgovyx, there is no doctor and hospital fees associated with injections, so she may be losing out on those - look at your EOB from your insurance company.


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Replies to "Well, I'm not a fan of physicians who do not believe in shared decision making. Did..."

Thanks for your thoughtful sharing experience. No, my doc is ask-only, no educational or empowerment, nothing along the lines of your recommended questions. I believe I would be better served by the Orgovyx. We will revisit in 2 months, but she has already set her limits by prescribing only those two drugs. I'm sure the money and control factors are at play with inoculations.