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CREON..Pancreatic enzyme supplement cost
Pancreatic Cancer | Last Active: Apr 3 8:09am | Replies (30)Comment receiving replies
The cost for Creon is the highest single medication bill we pay since my husband's total pancreatectomy. This year with the changes by March we had paid out a very large amount of money and then pop, now we are through some kind of a door and there is no cost to any of my husband's medications when using Medicare related Part D/ Wellcare Drug insurance. We just have found that being prepared to put out that amount at the beginning of each year will be the ongoing challenge and plan. I was fascinated with the free Creon from the Abbvie company by "whipple 2232" comment. You are fortunate. We even have had periods that we have had to search for a pharmacy source for the Creon and switching pharmacies for one that can access it. (We live in a large metropolitan area. ) We were doing well at our local Fred Meyer Pharmacy until a year ago and then poof, it was no where to be found. We finally did a mail order pharmacy, but found that it wasn't part of our Part D program at the beginning of the new year. Currently we are getting it through Costco, but we must give them heads up to have it on hand. Clearly far more expensive and difficult to obtain than insulin. The bottom line is that without an adequate dose of Creon absorption will not happen well. He was on a lower dose for sometime after surgery with multiple stools daily, an increase to 36,000 pill size doses changed that to more normal stool pattern, thus increasing absorption for him. What was fascinating to me was to learn that without taking the prescribed proton pump inhibitor, an alkalinizing medication) 30 minutes before the first meal of the day his stomach would stay acidic. When the stomach is acidic then the Creon breaks down there reducing its usefulness rather than below that in the intestine where the absorption for many nutrients takes place. We found also that iron and calcium want acidic stomach fluid to begin their digestion at that point, so due to that he has deficits in iron and calcium levels. (He also has no pylorus, lacks 1/3rd of his stomach, has no duodenum, spleen or gallbladder. Thus missing a lot of enzyme.) There are some absorptive qualities of iron & calcium ongoing in the small intestine that supports absorption but he has had to have IV ferritin twice during the last 5 years post pancreatectomy although we document the iron intake and it is over twice that of the minimum daily needed and he isn't on chemo now. This is my understanding, check with your prescriber on that information as everyone may have a bit different surgery and thus medication needs. Only follow your prescriber's advice. His exhaustion decreased with the Ferritin infusion from his oncologist. Just this week he received an infusion of Zometa for bone hardening to decrease the osteoporosis. He is also 80, so there are likely lifetime issues that precipitates his needs. Our Endocrinologist for diabetes is also a bone specialist. I have found that asking questions for guidance ongoing from our medical team is the most informative and healthful way to precede, with the problems. No one answer fits all.
Replies to "The cost for Creon is the highest single medication bill we pay since my husband's total..."
The new medicare out of pocket max is $2000 a year for prescription drugs. Sorry to strike a political point here but that was passed under Biden's IRA (inflation reduction act).
So when my wife spends her first $2000 for prescriptions, all drug costs for the remainder of the year is zero. ZERO! That means a lot when she also takes Creon, but she takes many more than your husband and we were spending between $500 and $1200 a month depending on whether she was in the initial stage, doughnut hole or catastrophic stage. But now $ZERO after the first $2000 out of pocket. My wife also takes a drug that if someone didn't have insurance would cost $18,000 per "month". But now $ZERO after the first $2000.
- More important. You say your husband had his pyloric and duodenum removed with the pancreas. And he takes an antacid proton pump inhibitor? Like you said, with a normal duodenum the acid is neutralized when it goes into the duodenum. But without the duodenum, acid goes into the jejunum (the part of the small intestines that comes after the duodenum) that the surgeon now attached to the stomach since he/she cut away the pyloric and the duodenum. So if not neutralized by the proton pump inhibitor, this acid can cause ulcers in the anastomosis (the connection made by the surgeon to the jejunum). So taking the PPI (proton pump inhibitor) can prevent damage from the acid.
How do I know all of this? My wife is an eight year pancreatic cancer survivor without a pancreas, pyloric, duodenum, spleen, gallbladder and just had a life threatening gastric bleed. Please speak with your husband's pancreatic surgeon about taking the PPI indefinitely, like forever.
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If you go to Medicare.gov website and look for the Drug coverage (part D) plans. You will need to sign in if you have not already signed up for an online Medicare account for your part A&B. then log in. Then look for Drug plan info and for the medicare.gov/plan-compare link. At that site you can enter all your meds that you purchase. After you enter all the meds you can look up plans and what they will cost you a year. Some plans will be slightly different than others. Mostly the same but they just move deductible around and premiums. And the total price a year will vary only a little. If you want 0 deductible, you pay higher premiums. Less premiums then higher deductibles. You can also choose 5 pharmacies to compare costs. In 2023 Mail order was the lowest cost for 3 months supply. I changed to a less expensive AARP United plan this year and lowest cost is for me to go to my local Walgreens retail store for 3 months supply. Not to worry though as the price savings for 3 months is not a supper great deal over one month so if you need to just order one month you can. If you have a part F or G supplemental or medigap plan and part D drug plan you can change and update your Part D plan every year as your need change. My 2023 part D plan went away and I had to change. But I had that old plan for several years. And you don't have to change every year. Now if you have an Advantage plan then you are pretty much stuck with being in a drug buyers' group with group discounts and no real insurance paying part of the cost of drugs. Not a bad deal if you have little or no medications but if you have expensive ones then it will end up costing more in the long run. Any way lot of good info over on medicare.gov and plan-compare. If you are on Medicare or going to be very soon that is where to look for information on part D plans and what they cost you.