The maximum you pay Medicare all year is $2000 for ALL drugs. That means the first Month is your yearly expense, all prescription drugs are free from there on for the rest of the year?
How about abiraterone?
Apparently it's the same thing. Any cheaper?
Xtandi (enzalutamide), a drug used to treat advanced prostate cancer, is not publicly funded in New Zealand.
It is considered clinically equivalent to abiraterone, another prostate cancer treatment that is funded.
How about abiraterone?
Apparently it's the same thing. Any cheaper?
Xtandi (enzalutamide), a drug used to treat advanced prostate cancer, is not publicly funded in New Zealand.
It is considered clinically equivalent to abiraterone, another prostate cancer treatment that is funded.
Abiraterone (Zytiga) is a first-generation ARSI. You usually have to take it with a steroid, which brings its own side-effects.
Enzalutamide (Xtandi) is one of the second-generation ARSIs (together with Darolutamide and Apalutamide, the so-called "-lutamides"). They sometimes have lower side-effects and are far more effective, including significantly longer overall survival, but obviously, everyone's medical situation is different and they may or may not be suitable for you.
So Abiraterone and Enzalutamide do play the same role (trying to prevent cancer cells from receiving testosterone signals), but they're not interchangeable. They're like a v.1 and v.2.
Abiraterone (Zytiga) is a first-generation ARSI. You usually have to take it with a steroid, which brings its own side-effects.
Enzalutamide (Xtandi) is one of the second-generation ARSIs (together with Darolutamide and Apalutamide, the so-called "-lutamides"). They sometimes have lower side-effects and are far more effective, including significantly longer overall survival, but obviously, everyone's medical situation is different and they may or may not be suitable for you.
So Abiraterone and Enzalutamide do play the same role (trying to prevent cancer cells from receiving testosterone signals), but they're not interchangeable. They're like a v.1 and v.2.
How about abiraterone?
Apparently it's the same thing. Any cheaper?
Xtandi (enzalutamide), a drug used to treat advanced prostate cancer, is not publicly funded in New Zealand.
It is considered clinically equivalent to abiraterone, another prostate cancer treatment that is funded.
There is now generic Abiraterone available in the US much cheaper. And it is covered in the US by Medicare, which now has a $2000 per year cap on what men pay out of pocket for prescription drugs. It must be taken with prednisone, which is dirt cheap.
I think the baseline U.S. patent for Enzalutamide/Xtandi (the oldest -lutamide) expires in 2027. It will be interesting to see if oncologists who currently nudge patients towards Abiraterone suddenly change their tune when there's a cheap generic -lutamide available and U.S. private insurers are no longer objecting to the extra cost. 🤷
I think the baseline U.S. patent for Enzalutamide/Xtandi (the oldest -lutamide) expires in 2027. It will be interesting to see if oncologists who currently nudge patients towards Abiraterone suddenly change their tune when there's a cheap generic -lutamide available and U.S. private insurers are no longer objecting to the extra cost. 🤷
These drugs last only so long before your body starts to have a rise in PSA. I was able to stay on abiraterone For 2 1/2 years before moving to Darolutamide. I would hope Darolutamide will work for three or four more years. I know it’s very unlikely that abiraterone would last 5 1/2 to 6 1/2 years before my PSA would start rising. I think using both has given me more time.
These drugs last only so long before your body starts to have a rise in PSA. I was able to stay on abiraterone For 2 1/2 years before moving to Darolutamide. I would hope Darolutamide will work for three or four more years. I know it’s very unlikely that abiraterone would last 5 1/2 to 6 1/2 years before my PSA would start rising. I think using both has given me more time.
In contrast, the TITAN study showed a significant advantage of starting on Apalutamide with ADT right away for mCSPC (to the point that they had to unblind the study partway through, because it would have been unethical to leave the control group on placebo).
Starting on Abiraterone and then progressing is part of the old-school thinking (try one thing, then move on something stronger when it fails); as you know as well as or better than I, the new thinking over the past few years is to hit metastatic prostate cancer hard up front with the best you've got (hence doublet and triplet therapy).
That doesn't mean the older approach is necessarily wrong; it will take many more years of research to establish that definitively.
The maximum you pay Medicare all year is $2000 for ALL drugs. That means the first Month is your yearly expense, all prescription drugs are free from there on for the rest of the year?
Connect
Connect
Like
Helpful
Hug
The maximum you pay Medicare all year is $2000 for ALL drugs. That means the first Month is your yearly expense, all prescription drugs are free from there on for the rest of the year?
-
Like -
Helpful -
Hug
1 Reactionomg, thank you! I was about to go berserk thinking I had to pay $24,000 a year for one pill!
I'm not sure my life is worth $24,000.
One battle is with the cancer itself. A more confusing battle is trying to understand our medical and insurance systems.
-
Like -
Helpful -
Hug
2 ReactionsHow about abiraterone?
Apparently it's the same thing. Any cheaper?
Xtandi (enzalutamide), a drug used to treat advanced prostate cancer, is not publicly funded in New Zealand.
It is considered clinically equivalent to abiraterone, another prostate cancer treatment that is funded.
Abiraterone (Zytiga) is a first-generation ARSI. You usually have to take it with a steroid, which brings its own side-effects.
Enzalutamide (Xtandi) is one of the second-generation ARSIs (together with Darolutamide and Apalutamide, the so-called "-lutamides"). They sometimes have lower side-effects and are far more effective, including significantly longer overall survival, but obviously, everyone's medical situation is different and they may or may not be suitable for you.
So Abiraterone and Enzalutamide do play the same role (trying to prevent cancer cells from receiving testosterone signals), but they're not interchangeable. They're like a v.1 and v.2.
Oh, ok. Good to know.
-
Like -
Helpful -
Hug
1 ReactionThere is now generic Abiraterone available in the US much cheaper. And it is covered in the US by Medicare, which now has a $2000 per year cap on what men pay out of pocket for prescription drugs. It must be taken with prednisone, which is dirt cheap.
I think the baseline U.S. patent for Enzalutamide/Xtandi (the oldest -lutamide) expires in 2027. It will be interesting to see if oncologists who currently nudge patients towards Abiraterone suddenly change their tune when there's a cheap generic -lutamide available and U.S. private insurers are no longer objecting to the extra cost. 🤷
The thing is, using abiraterone first can give you an extended amount of time of non-progression of your cancer. This Lancet article discusses why using abiraterone first makes sense.
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(19)30688-6/abstract?mc
cid=c2dca8aa74&mc_eid=99575fc699
These drugs last only so long before your body starts to have a rise in PSA. I was able to stay on abiraterone For 2 1/2 years before moving to Darolutamide. I would hope Darolutamide will work for three or four more years. I know it’s very unlikely that abiraterone would last 5 1/2 to 6 1/2 years before my PSA would start rising. I think using both has given me more time.
-
Like -
Helpful -
Hug
2 ReactionsIn contrast, the TITAN study showed a significant advantage of starting on Apalutamide with ADT right away for mCSPC (to the point that they had to unblind the study partway through, because it would have been unethical to leave the control group on placebo).
Starting on Abiraterone and then progressing is part of the old-school thinking (try one thing, then move on something stronger when it fails); as you know as well as or better than I, the new thinking over the past few years is to hit metastatic prostate cancer hard up front with the best you've got (hence doublet and triplet therapy).
That doesn't mean the older approach is necessarily wrong; it will take many more years of research to establish that definitively.
-
Like -
Helpful -
Hug
2 ReactionsMight have to check the plans formulary, could be a potential issue.