Lupron or Not at 76?

@tbgb50
This year Medicare has a maximum for what you will pay for drugs. It is $2100. I hit that in January this year when I ordered Darolutamide. From then, on all my drugs were free for the rest of the year.

I read that for 2027. It will be $2400 but I have not seen that confirmed in other articles.

@jeffmarc
This is literally the $64K question. I only take one generic blood pressure medication (never met the deductible) so I never really learned much about how Part D works. My understanding (definitely could be wrong) is that the medication must be in the formulary for your plan, so it's on my todo list for today. I'd pay $2400 in a heartbeat.

@utahgearhead
Thanks for sharing. Being a widower, I have too much time alone to obsess over everything and no sounding board when I get in a loop.

I think this is exactly how I feel:

"We will see outcome later but i have a whole new appreciation for the horrible side effects men on ADT deal with because its the question is the cure worse than the disease?
Quality of life is me now. Quantity of life, I’ve adjusted my want."

@michaelcharles
Thanks, this is helpful. My sister manages the office for a team of oncologists so I got a long distance second opinion (she's in NY, I'm in AZ). from two of them. So far their advice has been consistent but no one, including my medical team even mentioned Orgovyx.

To be fair, I have not had the last appointment with the urologist before the treatment begins but am skeptical because I was told he will administer the shots i.e. a possible financial incentive to make a specific recommendation. If he doesn't mention any of the alternatives I learned on this forum, I'm probably going to get a formal second opinion from Mayo Clinic which is close by.

My understanding is that ADT injectables such as Lupron are covered under Medicare Part B and therefore require less patient involvement with prescription costs under Part D and coinsurance or copay issues. Also, patient compliance is "guaranteed".
I have no reason to think that it is a revenue issue.

@tbgb50 I’m not a widower, sorry for your loss, but I’m also dealing with a loss/betrayal. You may smile, I do too now.

A woman showed up on my doorstep 4 years ago after 20 years silence. Within 2 months she moved in, deeply in love with me and I fell in love again. Nursed her through a hysterectomy and stuff. Lived with me for 3 years. Last August 2025 I had a routine TURP scheduled (to help peeing) which went well.

While I was literally in the surgery theater, she spent the time packing up & moving out but waited til I got home so she could witness my reaction. I was too drugged up to care so. She left without explaining & never contacted me since. The next week I got the news I have PC. That sent me into a terrible depression & tailspin that a year later I’m surprised I feel as good as I do going into SBRT next week.
And now that I know who she is I shake my head and smile sometimes. Still can’t believe how she left. 😊

@michaelcharles now I know all of that and I understand why the injection is covered. I just wish someone would have verbally said that to me about choice. And I know the daily pill can be missed by human error.

A lot couldn’t afford the additional costs, me too probably. I learned all this after I had the injection. I had the injection because at the time with all the test results I was just going along with my first care team suggested. I am elated I got the second opinion because I wasn’t going to but at last minute I did.

@tbgb50

There are no certainties in making treatment decisions...

Generally, there are good choices, occasionally I see on the forums people who may not make a good choice, aka, deciding to die of prostate cancer than "endure" the treatment. I've peaked behind that door, no thanx!

As I've said, a lot of variables go into the treatment decision. Financial toxicity as a result of insurance such as you mention about Orgovyx.

Of the treatment choices you mentioned, there is nothing "wrong" with any of them.

Still, I think the forum's consensus would be radiation only may not be a top choice.

Just because your initial treatment plan says X months of systemic therapy, doesn't mean you have to follow that to the end. In both cases I've done systemic therapy we've de-intensified early based on my responses.

Sometimes, you look at the data and it may say the difference in PFS is seven months or so. That may lead you to ask, "is 12 more months on treatment worth the seven months...!? My answer, no.

It would be nice to have a black and white checklist to go down and decide, "if this, then that...!"

There isn't!

But, wealth of experience on this forum so you can always bounce your ideas off the members!

Kevin

I have had prostate cancer since 2009. I have been on lupron since 2011. It has kept my PSA level below one. I am now 73 years old in my PSA is now at 1.8. Just last week, my doctor put me on Abirateone acetate to reduce my PSA level. So Lupe has been working for me all the way up until now and I have not complained once.
good luck.

@tbgb50 don't miss the surgery too much. It is not a walk in the sunshine. Both options work very well! They have both their own pros and cons. Take it easy, at least you don't have to make a decision. It's a difficult one.

I am sorry to hear that your wife has passed away. Good that you have found this site, you get excellent information here and some company.

My husband is 5 months post surgery and 8 months post diagnosis. Thanks for asking, he is much better now. Does what every man does on this site: try to stay positive and try to be brave. You will be much better in 8 months time as well!