Verzenio: How are you paying for this ridiculously expensive drug?

Posted by mjwhearts22 @mjwhearts22, Aug 21, 2023

Hi. I’ve finished both chemo and radiation treatments and now my oncologist wants me on Verzenio but at a starting price of $2850 a month we can’t do this. We applied for financial support from Lilly and was rejected. We are living off social security and a couple of minor income streams because cancer forced me to quit working. Medicine is either for the very wealthy or those not making much money. We middle class citizens are being squeezed out! It’s shameful! This drug gets more expensive with every dose change. I’m supposed to be on it for 2 years. Any ideas?

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@mjwhearts22
I feel for you and agree the middle class is always in a tight spot. Like you, I stopped working due to cancer. I am taking Kisqali (similar to Verzenio and Ibrance). Employer group insurance is great for meds because they are included in the annual out-of-pocket limit so affordable. Medicare part D, not so affordable for expensive meds since there is no out-of-pocket limit and supplement plans don't include meds.

Check into the financial requirements for Kisqali (manufacture Novartis) and Ibrance (manufacturer Pfizer) assistance programs. If you qualify, maybe your oncologist will consider switching you to one of the other similar meds. At first glance, it seems your income can be a little higher for Kisqali than Verzenio so if you were close to qualifying for Verzenio, maybe you'll qualify for one of the similar meds.

The oncology office told me there are also third party grants for financial assistance, but because breast cancer is so prevalent, when a grant becomes available, it is usually gone in minutes. You can try to be the first one to grab one of those. Not sure how you find them. Your oncology office should have a staff member that helps with this stuff.

One other thing about Kisqali, is apparently everyone can qualify for one free month. Maybe Verzenio is the same while you're weighing your options?

Remember to keep track of all your medical expenses for tax deductions if your expenses are high enough to meet the requirements. Best of luck!

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@californiazebra

@mjwhearts22
I feel for you and agree the middle class is always in a tight spot. Like you, I stopped working due to cancer. I am taking Kisqali (similar to Verzenio and Ibrance). Employer group insurance is great for meds because they are included in the annual out-of-pocket limit so affordable. Medicare part D, not so affordable for expensive meds since there is no out-of-pocket limit and supplement plans don't include meds.

Check into the financial requirements for Kisqali (manufacture Novartis) and Ibrance (manufacturer Pfizer) assistance programs. If you qualify, maybe your oncologist will consider switching you to one of the other similar meds. At first glance, it seems your income can be a little higher for Kisqali than Verzenio so if you were close to qualifying for Verzenio, maybe you'll qualify for one of the similar meds.

The oncology office told me there are also third party grants for financial assistance, but because breast cancer is so prevalent, when a grant becomes available, it is usually gone in minutes. You can try to be the first one to grab one of those. Not sure how you find them. Your oncology office should have a staff member that helps with this stuff.

One other thing about Kisqali, is apparently everyone can qualify for one free month. Maybe Verzenio is the same while you're weighing your options?

Remember to keep track of all your medical expenses for tax deductions if your expenses are high enough to meet the requirements. Best of luck!

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Thank you kindly. I’ll look into all this and ask my oncologist if she thinks Kisqali would have the same efficacy of Verenzio for me.

My best to you and I’m so grateful for your thoughtful response here.

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To: mjwhearts22my cousin lived in Georgia and told me if a woman had breast cancer she can get help with Medicaid. They told her it didn’t matter how much money you have because it will drain you dry. Her and her husband was in middle class making good money and she got the help from Medicaid paying nothing. She passed away, but not from cancer. She had an aneurysm. I’m in lower class and live in Alabama and also got on Medicaid. I know it is easier for me because of being in lower class. On SS and my husband past 4 months before finding out I had breast cancer in 2013. The kept me on Medicaid and sill on it, I guess because my cancer came back in 2018 and now it has spread to my lungs. Not from smoking. I don’t smoke. I’m praying something can be done. If you haven’t already tried, go to Medicaid and ask. All they can say is no. Best wishes.♥️♥️🌹🌹

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Are you on Medicare? If so, the below link may apply to you....if not I think you may want to discuss with your Oncologist alternative meds. I am a firm believer that financial toxicity from cancer is a real thing and a real health concern.
Also Fall is when most employers, Medicare and Marketplace insurance have open enrollment. You may be able to find insurance that does cover it. Wishing you the best and good health!

https://www.goodrx.com/verzenio/medicare-coverage?form=dose-pack&dosage=14-tablets-of-50mg&quantity=4&days_supply=&label_override=Verzenio
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@mjwhearts22

Thank you kindly. I’ll look into all this and ask my oncologist if she thinks Kisqali would have the same efficacy of Verenzio for me.

My best to you and I’m so grateful for your thoughtful response here.

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Also your local cancer centers will have grants sometimes or know if there are local organizations who might.

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I agree with comments from others, talk to your oncologist/nurse about applying for Lilly Cares. I am retired, on Medicare, and income from Social Security and pension. Based on Lilly Cares criteria, I did not qualify. When I shared this with my oncologist, they got involved and I was soon approved.
A word of caution about these meds, I was on a trial Kisqali (Ribociclib) beginning in 2019. In April 2021 I had an eye infection that resulted in corneal ulcer and loss of vision. In Oct. 2021 I developed an eye infection in the other eye with the same result, so now am legally blind, This family of meds do warn of infection, and Ribociclib emphasized respiratory, gastrointestinal and urinary tract infections as most serious. My opthalmologist researched this and told me these meds can be toxic to the eye. I don't share this to scare you, rather to have you be aware that any eye irritation while taking this med should be checked immediately for the beginning of a serious infection.
Hugs to you, praying for the best outcome!

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Y’all are right those meds are costly because they are made and can not get them from pharmacies. And the sides effects are worth looking into. I would look into your ki67 and oncotype score to see where you are low to high risk. I was also approached to taking verzenio however, my score are low -medium risks. And I didn’t have chemo before my journey so I opt out. And the side effects weren’t risking for 3 years. I am taking anastrozole now for the next 5-7 years. I was diagnosed in 2022. All do some heavy reading/ investigation before you agree. Hugs to all

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@chickenmom10

Y’all are right those meds are costly because they are made and can not get them from pharmacies. And the sides effects are worth looking into. I would look into your ki67 and oncotype score to see where you are low to high risk. I was also approached to taking verzenio however, my score are low -medium risks. And I didn’t have chemo before my journey so I opt out. And the side effects weren’t risking for 3 years. I am taking anastrozole now for the next 5-7 years. I was diagnosed in 2022. All do some heavy reading/ investigation before you agree. Hugs to all

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Just finished my treatment on anastrazole. Very few side affects. Diahrea and some hair loss. Did fine and now my
Med journey is done. I used Caremark for my
Meds mail order. They don’t charge any copay for cancer drugs.

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Wonderful news. What kind of cancer and stage did you have? How long were you taking anastrozole?

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@nanna1948

Just finished my treatment on anastrazole. Very few side affects. Diahrea and some hair loss. Did fine and now my
Med journey is done. I used Caremark for my
Meds mail order. They don’t charge any copay for cancer drugs.

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Congratulations, this is an inspiration to those that come after. You rock!

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