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Forteo Costs
I will be starting Forteo soon. My medicare plan D covers both Forteo brand and Teriparatide generic. My monthly cost is roughly $1500/mos. Is anyone aware of additional programs to cover the cost? I'm not eligible for the Forteo Savings card as I'm on medicare. Nor am I eligible for the Lilly Foundation program as my income is over $78k.
Second question. From what I've read so far it looks like the cost of needles is not covered in the plan costs, rather an additional cost outside the plan. If this is correct, where are you purchasing these needles and what is the ball park cost?
I'm hoping my questions will help others as well.
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Is this a price for someone on Medicare?
In reply to connielongoria: Yes I am on Medicare.
Thank you so much! I wish these drugs weren't so expensive! It makes it near impossible to afford them.
So true!
But when they work.... they are magic!
It is the price of getting a measure of life back, now and for our future...priceless!
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3 ReactionsAfter 5 months of research, mainly from ideas gathered from this site, I decided to start Forteo. My endocrinologist did all of the tests I asked for, and I was finally ready to go. Then, the pharmacist called and I found out just how much this would cost. With my plan, it is $427.63 for a 28 day supply. I called my plan's Medicare advisor, and found out that beginning in 2025 the maximum Rx out of pocket would be drastically reduced which will make it affordable.
Also, as per your RX Advocates tip, I found my plan has a Medical Financial Assistance plan with tiers that will also be very helpful, and to my surprise, the income can be considerably higher than expected to qualify for even partial assistance. Utilizing all of the resources for financial help is a great idea.
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1 ReactionI was on Forteo for 2 years and it was fully covered by financial assistance. My income is higher than I could ever imagine would allow for any assistance. My doctors office kept encouraging me to submit the paperwork. I delayed because I didn't believe it would do any good.
What size clinic do you go to? The clinic I go to is large enough that they have a full time financial assistance position. I've often wondered it that made a difference.
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2 ReactionsThank you for your encouragement. I haven't yet applied, but I hope my outcome for assistance will be similar to yours. I'm a member of Kaiser Permanente, which is huge in California. If the MFA doesn't work out, I still have the fallback to the 2025 reduction in RX out of pocket, which will help. I haven't looked into the cost of needles yet, as per some of the above comments.
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1 ReactionI was Optum. It happened right about the time they were purchasing our clinic (a large one). I would say the staff person was hired before the Optum purchase.
I just started Forteo, last night being my second time. Regarding the cost and assistance, I also found the initial price to be a dealbreaker. I called the Medicare part of my health care program and was encouraged to apply for Medical Financial Assistance through my plan. I was initially hesitant because I didn't think I'd qualify, but after reading many comments on this site, I decided to apply and was awarded 50% reduction. Good luck.
*note regarding another comment, no, the needles are not included in the price but I found them to be very inexpensive, $8.50 for 100 on my plan.
See my update 11.11.24. I was awarded 50% reduction as part of my Medical Financial Assistance program, as encouraged by the Medicare team of my health plan.