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Part D Plan: Don’t see Clofamizine on list; Best plan for us.
Has anyone had this issue? I am a newbie with picking a plan D and have been including the potential drugs I may have to take with MAC and whatever else surfaces. Clofazimine doesn’t show up at all nor does Lamprene. I am in Northern CA. Curious as to what plans in my area people are choosing to cover all the drugs we might end up needing.
Thank you!
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@paxmundi In your situation, I would call the insurer and ask how they handle off-formulary medications. I did that for my (adult) daughter last year, and they handle it case-by-case.
My formulary doesn't cover clofazemine either, but I know someone who had it covered on my plan, so I won't worry about it.
@sueinmn As usual, great advice. I have been at Kaiser the whole time since I was eligible for Medicare and this is all new to me.
While we all have the same disease, we all have different insurance coverages
This is the NHS guidelines that they didn’t follow with me and ended up with drug induced lupus. But these are there guidelines that I found online later. Wish I would’ve researched everything before I let these doctors loose on me. I had clofazimine on my last treatment plan but given way to much 200mg a day it turn me bright pink and the dye was coming out of my skin and into the bed sheets and my clothes.
https://www.nhstaysideadtc.scot.nhs.uk/Antibiotic%20site/pdf%20docs/NTM%20guidance.pdf
Paxmundi, I was on Clofazimine for many months. There is no cost for that medication. You receive it directly from your pulmonologist at no cost. I have no idea why, that’s just the way it is.
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2 ReactionsPer our doc, Clofazimine was considered experimental and wasn’t on the Medicare or Tricare-4-Life formularies. It took a while for our doc to get it covered, but we were able to get it as a compassionate use medication through the specialty pharmacy at Penn. Good luck with the process; it can sure be frustrating.
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1 ReactionIn Canada that clofazimine is free from the drug manufacturer. Not sure about the US
@tomed Thank you for explaining this!
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2 Reactions@paxmundi My doctor was able to get me on Clofazimine through the SPIND Program (Single patient investigational drug). https://www.fda.gov/about-fda/center-drug-evaluation-and-research-cder/expanded-access-clofazimine.
It is considered a study so there is no cost for me. They have to mail the prescription because it is not available through a pharmacy.
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2 Reactions@mjb24 Many thanks for this info.