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ARPI use after radiation treatment may be an issue
Prostate Cancer | Last Active: May 17 11:19am | Replies (46)Comment receiving replies
@jeffmarc Unfortunately some insurance plans in the US will often not approve of Nubeqa or Xtandi. They will approve of Zytiga because it's a cheap generic.
My insurance last week approved of Nubeqa and my MO was surprised as she sees far more denials than approvals.
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@mrkoji
If you are castrate sensitive, then you cannot be prescribed Nubeqa Unless you have a metastasis.
I think the vast majority of people that get prostate cancer are in that situation. The drug that is recommended at that point is Erleada. You did not mention that one. Not saying it wouldn’t be rejected, but it is the one recommended for those people.
For a long time, Zytiga has been a choice for the first drug to use. If it causes somebody problems, then I’m pretty sure insurance would allow a lutamide.
Yes, it’s a difficult thing. People can’t always get what they want because insurance is looking at the bottom line. I think one of the biggest problems is that once somebody on Medicare hits the $2100 limit, which happens quickly with a lutamide, the insurance company has to pay for any increase costs not the government. This really can become prohibitively expensive. The government sets a limit, they should pay for it. That would make it a lot easier to get an expensive prescription.