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What's your experience with Orgovyx (relugolix)?

Prostate Cancer | Last Active: 6 days ago | Replies (185)

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@seasuite

The file said it's attached, but, I can't see it. In any case, here is the information:
Medicare Pharmacy Coverage Details
How your Pharmacy Part D Drug Plan Works
Your plan has 4 stages. The amount you pay depends on which stage you are in.
1 Deductible
In the deductible stage, you pay 100% for Tier 4 and Tier 5 drugs until you meet your $100.00 deductible. There is no deductible for drugs in other tiers.
Deductible Remaining
$0.00
Met: $100.00
$0.00 to $100.00
You're in Stage 2
2
Initial Coverage
In the initial coverage stage , you and the plan begin to share costs until you spend a combined $4660.00.
Initial Coverage Limit Remaining
$1,964.90
Met: $2,695.10
$0.00 to $4,660.00
3 Coverage Gap
In the coverage gap stage , you and the plan continue to share costs until your out-of-pocket spending reaches $7400.00.
Coverage Gap Limit Remaining
$5,995.52
Met: $1,404.48
$0.00 to $7,400.00
4 Catastrophic Coverage
The plan pays most of the costs for Medicare-covered drugs. The catastrophic coverage stage continues through the end of the calendar year.

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Replies to "The file said it's attached, but, I can't see it. In any case, here is the..."

Good luck. You may receive a break in the coverage gap stage; 25% copay, but I am not sure. It did not help me with a 25% copay anyway.

I have UnitedHealthcare Medicare Advantage through the State of Georgia. I just started Orgovyx in September. So far coverage has been excellent. First month was $79, second month was $82. I am hopeful that it will remain in that range. I was told that the actual cost was approximately $2,700 per month.