What’s the cost of Pegasys with good commercial insurance?

Easiest is to call yr son's pharmacy and ask them to run the cost for you. They can also tell you if there's an out of pocket cap on costs with his policy. Policy coverage varies like crazy.

Remember that insurance companies can change their formulary without notice.

The pharm may know if there's a payment program thru the manufacturer, but you are strictly at the mercy of what the company feels like giving away from time to time. There will be paperwork to complete.

Best of luck. It's very hard to pay for Peg and other, newer drugs in the U.S. because of cost.

PS, GoodRx can give you an idea of what you'd pay for Pegasys in your area. Price has come down somewhat from the initial price if $6k per month: https://www.goodrx.com/pegasys

Genentech makes Peg, and here is their help-with-payment page: https://www.gene.com/patients/patient-support-services

Important to remember that ALL meds given for ET are off-label, e.g., not approved for ET by the FDA. That gives insurance companies an out to decline payment. Most docs prescribe HU because it's generic, and many insurance policies have a blanket policy for generic drugs.

According to a study I read, HU has no benefit to middle aged ET patients unless over Asprin unless very specific criteria are met. Long term use can lead to other issues. Seems like Pegasys and Besremi are $6k and $9k unless you make $100k or less for there coupon. I doubt people making enough to pay that long term aren’t participating on this forum.

I'm 70, ET-CALR. On HU + ASA x 6 yrs. Blood counts stable in 400s. If I were under 60, I would certainly consider Peg or Besremi if I could afford it. There are psychological side effects, but more in older patients. In Europe, where interferon are much more widely used, patients get screened for depression and may be prescribed anti-depressants. Best to you and yr son.

Not sure what study you looked at. Of course there can be side effects with HU. I have none, but that often depends on the individual. Remember that HU has been around 50+ years, so effects are well documented. Peg and it's even more expensive sister, Besremi, are newer drugs, and long term effects are unknown. Interferon are the only drugs that MAY improve, vs control, ET. Jury is still out.

Sorry to throw more info at you and to give the impression of arguing. It would be great if your son has the means to try Peg. But there is a lot of unnecessary fear of HU out there, despite its having helped many people avoid clots and vonWillebrand Syndrome. I'm still kicking after 17 years with ET. Dad also had ET many years ago and was on HU. Lived to 82 and died of unrelated causes.

Do a google search on “ASH Clinical News No added benefit”. Read the first paragraph. I appreciate your feedback. It’s good to see real world experience.

Just so we're all on the same page, here's what yr referencing:

Cytoreductive treatment with hydroxyurea has been shown to reduce the risk of thrombosis in patients with essential thrombocythemia (ET) and high-risk features, which include age >60 years or prior thrombosis or hemorrhage. But patients aged 40 to 59 years who lack high-risk features do not benefit from addition of hydroxyurea to aspirin, according to results of an open-label, randomized trial published in the Journal of Clinical Oncology. Compared with aspirin alone, the hydroxyurea/aspirin combination did not reduce rates of vascular events, leukemic transformation, or myelofibrotic transformation in patients with "intermediate-risk" ET.

Based on these results, the authors, led by Anna L. Godfrey, BMBCh, PhD MRCP, FRCPath, from Cambridge University Hospitals National Health Service (NHS) Foundation Trust, recommended that patients age 40 to 59 years without other clinical indications for treatment (such as previous thrombosis or hemorrhage) and with platelet counts < 1,500×109/L should not receive cytoreductive therapy.
https://ashpublications.org/ashclinicalnews/news/4232/No-Added-Benefit-When-Hydroxyurea-Is-Combined-With

Hi,
Yes, I think her son is 38 and falls into that category so is why she is concerned.