Switching Aromatase Inhibitors: Questions about $ and drug plan

Posted by cfacarol @cfacarol, Oct 26, 2019

My oncologist recommended switching from Letrozole to Exemestane. I’m wondering if anyone has found the exemestane easier to tolerate. Also, it looks like out of pocket cost would be around $1,000 per year. I have Medicare and the aarp/UHC Drug plan, and applied the GoodRX discount. I could change drug plans. Wondering if there is a Medicare drug plan in Florida that will pick up more of the cost.

@cfacarol
I don't know about Medicare and discounts. I am in California and have Medicare Senior Advantage and also past employee of medical facility so only pay $5 for every 3 months. My experience is that I tried anastrozole which caused severe 24/7 headaches and bone pain, etc. and letrozole which caused severe bone pain. My oncologist switched me to exemestane about 2 months ago after giving me a 4-week break from the letrozole. I take this in the evening (as I did for the other two) to help decrease daytime dizziness and hot flashes. On the exemestane I still have hot flashes and sweats, however, I had uterus and ovaries removed at age 44 (now 68) and am used to those side effects (yuck), but I am not having the severe bone pain throughout my body. If I don't get any of that, I feel that I can stay on this drug. Recently, I did start a therapeutic water class twice weekly and try to keep walking three to four times a week. I also started using a product someone on this site recommended for pain, that of Topricin, which is holistic and contains arnica, calendula, etc, that I find helps with pain. Hoping you do well with this change. It's worth a try.

Liked by elizm

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@trixie1313

@cfacarol
I don't know about Medicare and discounts. I am in California and have Medicare Senior Advantage and also past employee of medical facility so only pay $5 for every 3 months. My experience is that I tried anastrozole which caused severe 24/7 headaches and bone pain, etc. and letrozole which caused severe bone pain. My oncologist switched me to exemestane about 2 months ago after giving me a 4-week break from the letrozole. I take this in the evening (as I did for the other two) to help decrease daytime dizziness and hot flashes. On the exemestane I still have hot flashes and sweats, however, I had uterus and ovaries removed at age 44 (now 68) and am used to those side effects (yuck), but I am not having the severe bone pain throughout my body. If I don't get any of that, I feel that I can stay on this drug. Recently, I did start a therapeutic water class twice weekly and try to keep walking three to four times a week. I also started using a product someone on this site recommended for pain, that of Topricin, which is holistic and contains arnica, calendula, etc, that I find helps with pain. Hoping you do well with this change. It's worth a try.

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@cfacarol @trixie1313
I've been using Topricin's Fibro Cream, too (for almost two years now) both for my CIPN and the bone/joint pain from anastrozole. Can't get through the day without it.

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@cfacarol @trixie1313
You have touched on one of the nightmares in American healthcare — finding a drug plan which is functional for one's needs and is affordable. (I have an employer-negotiated plan with OptumRx via UHC's Medicare Advantage, for example, which charges $14 for a 90-day supply of exemestane (which I don't take) and anastrozole (which I do take)). I went to the UHC site and searched Medicare Advantage Plans for St. John's County in Florida to use as an example which is perhaps close to your home. It notes 19 plans for that county, and that is from just a single provider (UHC). So you can see how daunting it is for shoppers. And, one would want to compare the drug plans to Medicare's Part D (which one has to pay for anyway, even when opting for a Medicare Advantage or Medicare Supplement Plan). The mind boggles….

One thought is to call UHC (and other providers) and ask if their drug plans change for their various Medicare Advantage plans?

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Cfacarol, I’m on the same boat with you… I’m also on Medicare with the AARP drug supplement through United Health Care. UHC iwon’t pay very much in my state. My out of pocket cost for Exemestane is nearly $200 a month. I’ve been very pleased with my AARP drug supplement until this issue with Exemestane. I have had dreadful side effects from both Anastrozole and Tomoxifin, so my doctor switched me to Exemestane. My side effects from Exemestane are very minimal compared to the other two drugs! I have bought a 90 day supply (at that high price) of Exemestane and it should last me until January. There are other Medicare supplement plans out there that will cover it. I have an appointment in early December with a specialist in Medicare supplements. He is not an insurance agent, but an advisor who is very knowledgeable and specializes in Medicare plans and supplements. His customers, like me, pay him directly for his time and advise, rather than him getting paid a commission from the insurance companies to ‘sell’ their product. I will be reviewing what’s available for coverage for all of my prescriptions at this annual visit with him, but mostly seeing what’s available to cover Exemestane. I don’t know yet if it’s best to go to another supplement plan than the AARP plan, but I do believe knowledge is power. I intend to become as knowledgeable as I can regarding costs of Exemestane, it’s working very well for me so far and I don’t want to give it up.

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@lisman1408

Cfacarol, I’m on the same boat with you… I’m also on Medicare with the AARP drug supplement through United Health Care. UHC iwon’t pay very much in my state. My out of pocket cost for Exemestane is nearly $200 a month. I’ve been very pleased with my AARP drug supplement until this issue with Exemestane. I have had dreadful side effects from both Anastrozole and Tomoxifin, so my doctor switched me to Exemestane. My side effects from Exemestane are very minimal compared to the other two drugs! I have bought a 90 day supply (at that high price) of Exemestane and it should last me until January. There are other Medicare supplement plans out there that will cover it. I have an appointment in early December with a specialist in Medicare supplements. He is not an insurance agent, but an advisor who is very knowledgeable and specializes in Medicare plans and supplements. His customers, like me, pay him directly for his time and advise, rather than him getting paid a commission from the insurance companies to ‘sell’ their product. I will be reviewing what’s available for coverage for all of my prescriptions at this annual visit with him, but mostly seeing what’s available to cover Exemestane. I don’t know yet if it’s best to go to another supplement plan than the AARP plan, but I do believe knowledge is power. I intend to become as knowledgeable as I can regarding costs of Exemestane, it’s working very well for me so far and I don’t want to give it up.

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Hello @lisman1408,

This is a good time to consult with people who are experts in the area of Medicare prescription plans. I hope that you find a plan that will help make Exemestane more affordable.
When will you be meeting with the advisor?

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@lisman1408

Cfacarol, I’m on the same boat with you… I’m also on Medicare with the AARP drug supplement through United Health Care. UHC iwon’t pay very much in my state. My out of pocket cost for Exemestane is nearly $200 a month. I’ve been very pleased with my AARP drug supplement until this issue with Exemestane. I have had dreadful side effects from both Anastrozole and Tomoxifin, so my doctor switched me to Exemestane. My side effects from Exemestane are very minimal compared to the other two drugs! I have bought a 90 day supply (at that high price) of Exemestane and it should last me until January. There are other Medicare supplement plans out there that will cover it. I have an appointment in early December with a specialist in Medicare supplements. He is not an insurance agent, but an advisor who is very knowledgeable and specializes in Medicare plans and supplements. His customers, like me, pay him directly for his time and advise, rather than him getting paid a commission from the insurance companies to ‘sell’ their product. I will be reviewing what’s available for coverage for all of my prescriptions at this annual visit with him, but mostly seeing what’s available to cover Exemestane. I don’t know yet if it’s best to go to another supplement plan than the AARP plan, but I do believe knowledge is power. I intend to become as knowledgeable as I can regarding costs of Exemestane, it’s working very well for me so far and I don’t want to give it up.

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Thank you for the response. I have researched other Medicare drug plans and some say they provide the exemestane cheaper. The lowest was around $600 per year. I am hesitant to change because The UNH care plan has been good….basically 0 copays. I do think their premium increase for 2020 is quite steep, from $28.10 to $34.20. Not really sure what to do. With my luck, I’ll switch and then end up taking an unanticipated drug that will be expensive under the new plan!

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@hopeful33250

Hello @lisman1408,

This is a good time to consult with people who are experts in the area of Medicare prescription plans. I hope that you find a plan that will help make Exemestane more affordable.
When will you be meeting with the advisor?

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Early December

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@hopeful33250

Hello @lisman1408,

This is a good time to consult with people who are experts in the area of Medicare prescription plans. I hope that you find a plan that will help make Exemestane more affordable.
When will you be meeting with the advisor?

Jump to this post

@hopeful33250
I don't know if this will be helpful or not, but in the Nov. 1, 2019 issue of BottomLine Personal is an article entitled "Best Medicare Advantage Plans" and, in the opinion of James Beem MHA, MA, managing director of global health-care intelligence at the data-and-analytics firm J.D. Power. they are 1) Kaiser Foundation Health Plan, 2) Highmark, 3) Humana, 4) Aetna, 5) Centene, 6) Anthem, 7) United Healthcare, and 8) Cigna HealthSpring.

Liked by trixie1313

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@elizm Well that makes me feel good….I am retired from Kaiser Permanante in Northern California!

Liked by lisman1408

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