1. < Hypertrophic Cardiomyopathy (HCM)

Why Camzyos instead of surgery?

Posted by joycehocm @joycehocm, Nov 12, 2024

I am just curious - once HOCM is diagnosed, why is Camzyos recommended instead of other treatments - like myectomy? (is that what once treated this? or ablation?). I am a complete novice here with a recent diagnosis - and mainly intermittent breathlessness. I have my first appointment at a COE on Friday. My local cardiologist said that I am a candidate for Camzyos and given the expense, I am curious about this. Also, can anyone tell me how they handle the expense? After help from a person's supplemental plan (if any) and from Bristol Myers, if approved, what do people end up paying for Camzyos?

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brumasterj | @brumasterj | 1 day ago
In reply to @joycehocm "Thank you - that is very helpful. I'm surprised that the cap or "maximum out-of-pocket" applied..." + (show)
@joycehocm

Thank you - that is very helpful. I'm surprised that the cap or "maximum out-of-pocket" applied since Camzyos isn't covered at all by medicare. I didn't realize that Tier 5 uncovered meds could be capped - oh well - easy to get confused. Your situation sounds great and is a relief to know that this can happen. I hope you continue to do well on the Camzyos.

Jump to this post

My insurance is United Healthcare and they consider Camzyos tier 3
I was really shocked last month Dec when they covered 100%
I think the meds is $9300 for 35 day supply
UHC will not do a 35 day they do a 30 day for me which cost $8800
That 30 days is really pushes it to the limit.
I had 1 pill left when my new prescription arrived.
You have to get your imaging done and consult with the doctor before they write a new prescription each month.
But from what i was told the camzyos has a long half life so if you miss a few days it still stays in your system!
Good luck with all your medical needs

REPLY
1 reply
joycehocm | @joycehocm | 23 hours ago
In reply to @brumasterj "My insurance is United Healthcare and they consider Camzyos tier 3 I was really shocked last..." + (show)
@brumasterj

My insurance is United Healthcare and they consider Camzyos tier 3
I was really shocked last month Dec when they covered 100%
I think the meds is $9300 for 35 day supply
UHC will not do a 35 day they do a 30 day for me which cost $8800
That 30 days is really pushes it to the limit.
I had 1 pill left when my new prescription arrived.
You have to get your imaging done and consult with the doctor before they write a new prescription each month.
But from what i was told the camzyos has a long half life so if you miss a few days it still stays in your system!
Good luck with all your medical needs

Jump to this post

Wow - very helpful! We have United Healthcare as our supplemental policy as well -- with Medicare being primary. So maybe this will all work out. I am going to Hopkins so I do have a REMS team and can go back and forth as needed. Your response shows that it is possible to be on Camzyos.

REPLY
1 reply
brumasterj | @brumasterj | 23 hours ago
In reply to @joycehocm "Wow - very helpful! We have United Healthcare as our supplemental policy as well -- with..." + (show)
@joycehocm

Wow - very helpful! We have United Healthcare as our supplemental policy as well -- with Medicare being primary. So maybe this will all work out. I am going to Hopkins so I do have a REMS team and can go back and forth as needed. Your response shows that it is possible to be on Camzyos.

Jump to this post

Yes when a camzyos rep reaches out to you they want you to be well informed and they too want to make sure its very affordable!
I know before i got on camzyos i reached out to UHC to find what my cost was going to be, they could not and would not answer the question.
The good thing is yku have a lot of people in the program that want to make sure its affordable to you, so dont sweat the cost, there going to make sure its affordable!
I been dealing with under diagnosed/misdiagnosed treatments for several years!
To the point to where i was thinking it was all in my head on my symptoms!
Camzyos has made a huge difference in my lifestyle in such a small amount of time!

REPLY
1 reply
joycehocm | @joycehocm | 22 hours ago
In reply to @brumasterj "Yes when a camzyos rep reaches out to you they want you to be well informed..." + (show)
@brumasterj

Yes when a camzyos rep reaches out to you they want you to be well informed and they too want to make sure its very affordable!
I know before i got on camzyos i reached out to UHC to find what my cost was going to be, they could not and would not answer the question.
The good thing is yku have a lot of people in the program that want to make sure its affordable to you, so dont sweat the cost, there going to make sure its affordable!
I been dealing with under diagnosed/misdiagnosed treatments for several years!
To the point to where i was thinking it was all in my head on my symptoms!
Camzyos has made a huge difference in my lifestyle in such a small amount of time!

Jump to this post

Wow - this is so reassuring! I was only recently diagnosed - but have great docs now. They are putting me on a calcium channel blocker and jardiance first and then probably Camzyos. I had also called United Healthcare before the end of open season to see which supplemental plan would be best - and they also would not or could not tell me (which I consider nonsense - they could tell a customer what the range of help they have provided in past is and whether or not you should be on standard option or high option - but nope - I truly feel for those without the support of education, skills and funds in our system). Thanks again - you have really made a difference in my life!

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