Navigating Biologics by McKesson for D and mail-order 90-day Orgovyx

Most prostate cancer drugs are Tier 5 (Specialty) drugs, and a standard pharmacy usually doesn't carry them. You'll need a mail order specialty pharmacy. I don't know if any you have listed provide Tier 5 meds.

I get my Orgovyx (and all prescription drugs) by mail. Takes 2-3 days.

Biologics by McKesson Appears to be compounded formulas created by specialist pharmacies. Never heard of anybody with prostate cancer doing this. What are they making up for you? You say D, Do you mean vitamin D which you can get everywhere.

There are multiple other drugs you can take with Orgovyx, Zytiga, Xtandi, Nubeqa or Erleada, What are you going to be taking?

No way to tell what’s going on when you’ve given absolutely no information about what’s wrong with you and test results you’ve had.

I have Wellcare Part D drug plan, was approved for Orgovyx 120mg a day. Wellcare mailed me a letter saying they would only approve Zytiga 500mg tabs for one month (have to take 1000mg a day) but they would approve 250mg tablets (4 tabs a day=1000mg) no problem. Sounds foolish to me but OK......Dr and specialty pharmacy took care of it. Next hurdle: Drugs could be mailed to me or I could pick them up...50 mile round trip. Mail them I said......cant deliver to a Post Office box they said. We can send them UPS they said....but UPS wont deliver to my house in the woods , too dangerous....lol...what? The banjo music scares them? Just as well, I dont want that big truck coming back here anyway. Send them to the hospital where I see my Dr.....Dr even said he would sign for them.... cant do it they said.....then they offered to send drugs by private delivery. OK I said, Ill meet them at the end of my half mile long driveway when they call. Ive done that twice and its working out...I rode my snowmobile out in Feb..... then the ATV in March, the driver said: sweet ride....cant wait to drive my 1958 jeep doodlebug out to pick them up in April....dirt bike in May...keep your sense of humor close....you are going to need it...welcome to the prostate cancer business model....it is a money making machine...and that is coming from my medical oncologist, he just said that to me this Wednesday.... my respect for him went up about 10 points......PCa has made my life very interesting, Im looking forward to what comes next.....radioactive infusions? Chemicals that make my hair fall out? Ive already been castrated...bring it on Doc, Im ready for round 3 of this bare knuckle fight!

McKesson Biologics and Onco360 are the only mail order pharmacies allowed to sell Orgovyx in USA (does not stop VA, Hospitals, and other sellers from delivering for their patients). Zytiga 4x250mg saves Wellcare about 40% over 2x500mg. There are usually $$$ involved in any restriction so they make you take 2 extra pills a day.

@jeffmark - Doc has been preparing me for upcoming Rad Therapy with meds Orgovyx and Nubeqa. I'd like to get the pharmacy and insurance 'ducks in a row' prior to that. The "D" shorthand in the subject/title was indicating Medicare Part D.
My positive margins and node-positive post prostatectomy (Grade 5) means some substantial changes on my part.

@stage4lovolmetpc - Orgovyx and Zytiga - daily, and I assume for many months. But they won't send you a 90-day supply? Is this Wellcare being not-so-well-care for us?

@krs03
The same thing with my medical insurance company. All the lutamides As well. You get a 30 day supply because they don’t know whether you’re going to be taking it for 90 days I suspect. These are the type of drugs that you just stop taking at some point and until Zytiga became generic the cost of the drugs made sense to cut it at 30.

@krs03
Yes, both drugs daily, and yes, many months, years, perhaps even for the rest of my life.
It took me awhile to accept it but thats where I am so might as well embrace it. Ill be pressuring the Dr to drop the Zytiga and prednisone and put me on Nubeqa but one small step at a time.
For me, the hardest part of this PCa experience was choosing The PDP plan and Medicare Medigap plan. As you know I chose Wellcare and it seems to be working out ok, I satisfied the out of pocket max ($2100) the first 2 months of 2026. The Medigap insurance was a bit more subtle...The "G" plan premium in my area is $383 a month. The "G+ (high deductible) is $79 a month with a 2950 deductible....if you do the math (I did), the plan G+ saves me $1000 a year for the same coverage. What is possible is that I may have to pony up the 3k right away, depending on the service (MRI, petscan or other expensive procedure) that PCa may require. I can do that, I planned for old age. But what about a person that cant come up with the 3k? They have to pay 1k more over the year. Its like the insurance company is charging interest on the coverage. Ok, Ill quit that rant, but my point is you (me) have to consider all the angles to make an informed decision, financial, medical, and personal so we end up with the best outcome ie: quality of life. 30 day drug supply vs 90 day is the least of our problems...lol.
I hope your procedure goes well and you wont have to take the ADT forever.