Connect
← Return to What's your experience with Orgovyx (relugolix)?
Discussion
What's your experience with Orgovyx (relugolix)?
Prostate Cancer | Last Active: 6 days ago | Replies (185)Comment receiving replies
It's great to find a thread specific to Orgovyx users! I've learned a lot already reading through and was initially trying to get a prognosis for my side effects. I started taking O 12 days ago and am feeling much better than expected. I get a number of daily flushes/flashes, but, they range from pleasant (when I am feeling cold) to a light sweat. I decided to take pills each evening after dinner thinking I'd sleep through most all symptoms and that has been the case so far. There are so many variables with different guy's experiences that I can't predict, with any level of accuracy, what will happen to me. However, I now see a more narrow range of possible outcomes.
I didn't see any comments on insurance coverage and net cost of the drug. Clearly, that will vary tremendously with a variety of factors. So far, I'm quite unhappy with the Cigna insurance coverage that I received for the first 30 day supply. I just started Medicare in May after leaving the company plan. I bought Cigna Medicare Extra Part D after asking for a plan with highest premiums and lowest co-pays. A 30 Days supply Coverage was:
Billed: $2,632.44
Plan Paid: $1,266.22
I Paid: $1,366.22 (includes $100 ded. which is now met)
Of course, I'm investigating with Cigna and Orgovyx what is going on and what they can do, if anything. So far, I'm hearing nothing but rejections for assistance. I am astonished when I read on the Orgovyx website:
IF YOU HAVE MEDICARE PART D: orgovyxpricing.com
3 out of 4 ORGOVYX patients paid
$100 or less per month on average*
That sounds like false marketing to me and they can't explain why I'm not 3 out of 4. I'm advised to fill out an application which then gets rejected.
While I likely won't qualify for low income assistance, I paid for Cigna's top plan knowing I might need pricey drugs and expected them to have more coverage. Hence, I'm wondering if anyone has had the same experience and what remedies may exist for a drug that has no generic or alternative other than a different class (agonist vs. antagonist)?
Replies to "It's great to find a thread specific to Orgovyx users! I've learned a lot already reading..."
What kind of Cigna insurance do you have? I have Cigna open access and wondering how much orgovyx will cost. Cigna said they need pre authorization before they tell me how much it is. My husband haha been told he will be given the 3 month shot of lupron. But when I read the side effects I prefer orgovyx. He did extremely well on his loading dose with dexitral.
Connect
Seasuite:
Orgovyx is covered under Medicare Part D. Prior to PCa, my only Rx meds were Tier 1/2 generics, with no or nominal copys and a rock bottom premium.
Orgovyx was a Tier 5 branded med with a 25% copay: $ 1100 first month, which included deductible; $ 725 / mo for next 3 prescriptions.
When you move to 3rd stage catastrophic coverage, your copay should be reduced significantly.
If cost is an issue, the injectable meds (Lupron/Eligard, etc) should be covered under Medicare Part B at what may be a significantly reduced out of pocket.
I have Original Medicare, together with a Supplement plan, and chose my separate Part D coverage.
Drug plan costs are challenging to understand in a "vacuum" and in advance of actually knowing what meds will be needed.
Hope this is helpful.