Who pays for this drug at $900 a shot. My insurance has held up payment for a month.
Who pays for this drug at $900 a shot. My insurance has held up payment for a month.
Hi Norm: My insurance paid for this the first year I was on it, with a copay for me of $60.00. On the second year the insurance co change the drug classification on this and the copay went up to 175.00 which I couldn't afford so I got samples from my Dr. I went from -3.6 to a normal bmd score. I'm done with Forteo now, and glad I took it!!!
Call your insurance co and find out what the hold up is. If they turn down coverage, you could file a *drug appeal,* or a *tier change* on the med. Hopefully they will pay for it, but if not, don't give up try for either of these options, which you have a right too legally.
Good Luck
Hi Norm: Forteo comes in a preloaded pen that has 28 doses in it. You use the pen for 28 days and then discard it. It has to be kept in the refrigerator between 36 and 46 F., so the 28 days (1 pen) cost me $60.00.
The shot is really simple, and doesn't hurt. You go to a class where they show you how to use it. Sometimes you have to bug insurance co's, to tell you what there decision is. and appeal if they turn you down.
Good Luck
Hi Norm: Here are two links that can help to explain Forteo.
http://www.ccjm.org/pdffiles/DEAL703.PDF#search=%22forteo%20and%20osteosarc oma%22
http://pi.lilly.com/us/forteo-pi.pdf
There also one from the FDA, that I didn't post, so if you are interested in it let me know.
I went to Neil's link and it's a website promoting commerical alternative medicine products. How does the National Osteoporosis Foundation feel about their board being used to promote commercial products?
Rosaflor, you may have missed the post from the volunteer moderators that sale or promotion of any product is not permitted by NOF and will be reported to the Inspire team. Thanks for your post. Sandi NOF Volunteer Moderator
My insurance (medicare A &B) RX through AARP - now has me in the donut hole (I started on Forteo in May) so I have to pay approx $775 per syringe. No help anywhere else - I have called everywhere - nothing and I have over a certain amount in savings so I don't qualify for any kind of aid or help. I don't know what I would do if I had to be on this for more than two years. As it is I will have to dip into my savings as my soc. sec monthly payments would be cut in half if it used that. Why do the drug companies pull this? Shame on Lilly.
Hi hofffazio: Have you asked your Dr for samples? I had to do that when I went into the coverage gap on MC. Dr.'s have samples-full size pens-that they *have* to give away before they expire. If the Dr. runs out of samples Eli Lily just gives them more pens. When I asked my Dr. for the samples 1 year into my tx she said no problem.
Good Luck..
No but I will be asking - I just received a 90 day supply - but come the first of the year when I start anew with prescriptions I will be asking and see what I can get - what is the max # of pens you were able to get from your Dr.
Here is an interesting article about a gene for Osteoporosis. I forgot my med on a trip so we did a turn around and came 200 miles back to get it after we had travelled 150 miles then turned around and went back to where we were going - I am going to put a FORTEO sign in the car on the dash from now on so right before we leave so I won't forget it. I have it in the kitchen but never thought to put one in the car as I have been really good about packing it at the last minute. What does taking Forteo through the security at the airport do to it - lessens the potency or what?
Science News
Print Email Bookmark
Scientists Identify A Candidate Gene For Osteoporosis
ScienceDaily (Mar. 29, 2007) — Researchers report the identification of a gene that may play a role in susceptibility to osteoporosis--the crippling disease that leads to bone fractures, especially of the hip and spine. The study, conducted by scientists at the Musculoskeletal Diseases Center of the Jerry L Pettis Memorial Veteran's Affairs Medical Center at Loma Linda, shows convincing evidence that a gene called DARC negatively regulates bone density in mice. The report appears online in Genome Research.
________________________________________
"If our finding using the mouse model is confirmed in humans, then we may be able to develop therapies that are based on inhibiting the function of the DARC gene," explains Dr. Subburaman Mohan, Ph.D., a Senior Scientist at the Loma Linda VA Medical Center and a Professor of Medicine and Biochemistry at Loma Linda University. "We will also be able to develop genetic screens to identify individuals who are at risk for osteoporosis."
According to the National Osteoporosis Foundation, osteoporosis affects 55% of Americans over the age of 50. Low bone mineral density (BMD)--the primary indicator of osteoporosis--is influenced by both genetic and environmental factors (e.g., diet or medication). But the genetic element has been difficult to characterize because bone growth is controlled by many genes, including those for various hormones, growth factors, signaling molecules, and structural components of bone and cartilage.
Previous genetic studies had pointed to a region on mouse chromosome 1 as containing a gene responsible for BMD regulation. In the current project, Mohan and his colleagues honed in on this region of chromosome 1 using a variety of molecular techniques, and they located a gene called DARC (Duffy Antigen Receptor for Chemokines) that exhibited different levels of expression in mice with higher BMD. The analogous chromosomal region has also been shown to influence osteoporosis in humans.
The protein encoded by DARC binds to chemokines--or small signaling proteins--that are involved in osteoclast formation. Osteoclasts break down bone in a process called bone resorption, releasing important minerals such as calcium, phosphate, and magnesium into the bloodstream. This causes a reduction in BMD.
To confirm the involvement of DARC in regulating BMD, Mohan's team characterized the skeletal phenotype of mice with and without the DARC gene. The DARC-knockout mice exhibited increased BMD and lower bone resorption compared to mice with the DARC gene, supporting the predicted role of DARC in hastening bone resorption. They also showed that antibodies to the DARC protein, which effectively blocked the action of DARC, inhibited the formation of osteoclasts.
Although the researchers have identified a number of DNA alterations in the DARC gene, they did not pinpoint the specific alteration that was responsible for the BMD differences between the two strains of mice. However, Mohan and his colleagues predict that changes in the amino acid sequence or alterations in regulatory regions of the DARC gene may lead to key functional changes.
"There are interesting differences between African Americans and Caucasians that could be associated with this gene," explains Mohan. "African Americans exhibit significantly higher BMD compared to Caucasians. Also, African Americans generally do not have the Duffy protein on red blood cells, while Caucasians do. The potential genetic association between DARC gene variation and these traits in humans certainly makes it worthy of further investigation."
________________________________________
Adapted from materials provided by Cold Spring Harbor Laboratory, via EurekAlert!, a service of AAAS.
Hi hofffazio: I've never traveled with forteo except in the car. I think some of the others could answer this question better. I'm assuming you are referring to the x-ray check? I don't know what that does, but there is metal in the pen so it could alter the way the pen injects the medication-but that's just a guess. Eli Lily says that you should not let it be x-rayed.
I don't think there is a limit on the number of sample pens you can get, it just depends on how accommodating your Dr.'s personality is. Like I mentioned, I went into the donut hole/coverage gap in March, so I was able to get samples to finish out the year from March to Dec.
Hey great minds think alike... I posted the same article that you did above, and one of the Dr.'s working on this is my Dr., I posted it under the heading of "New Candidate Gene for Osteoporosis" I think :) or words to that affect.
So if you just got a 90 day supply (3 pens) then you only need 1 more for Dec-right? Once the new year starts the calculations for the coverage gap start all over again, so if you are running out in Dec this year you won't run out till Dec next year, *unless* your rx's change dramatically to more expensive meds. With MC part D, the calculation to determine when you've reached the coverage gap starts new every year-does that make sense? So every Jan you start at 0 spent and then they keep track of what you spend as the year progresses, to figure out when you've reached the limit and the gap starts again. You are doing really good if the your gap doesn't start till Dec, unless I calculated that incorrectly. Now if you just paid cash for that 90 day supply you got and your insurance didn't cover it, then your cov gap starts in Sept.
Good Luck, remember that the drug co's give out the samples for patients to use, and not all Dr.'s have a lot of patients on Forteo so sometimes they have way too many samples and need to give them away before they have to throw them out on the expiration date.
Good Luck...
Forteo has been recommended for me, too. I have been reading on this website many notes about the cost--from $600 to $900 per month. It is not any price per "shot" As it was belatedly explained to me by one doctor taking Forteo involves 18 months of DAILY self-administered injections. Perhaps that is only one way that it is administered, but as far as I know (this information from NYC's Beth Israel's Dept. of Rheumatology) this is the deal. I am concerned about whether Medicare pays for it or how much would be paid for under Plan D because if I started now half-way through the course I would be under Medicare.
We need to gather real research not just anecdotal stories. I would imagine at this price it would be cheaper to fly to Argentina (preferably as a courier) and buy a quantity and come home. Or Canada or Mexico. Of course in the UK we would be paying their minimal co-pay. What's up with this government that doesn't take care of its citizens? Those of us who are entereing the "third age" as being over 65 is so elegantly described in Europe and elsewhere are going to be the one with the highest medical expenses. Best to all, Michele
Hi Suzanne: I like the idea of flying to Argentina, or going to Canada etc,. the only problem is Forteo isn't available in Europe or Canada at the moment and I would doubt if you could get it in Mexico; it wouldn't be made by Eli Lily, since there isn't a generic for this, were stuck. But I realize you were probably just joking :)
It isn't whether Medicare pays for this or not, it's whether your individual part d insurer does. When I started on Forteo 2 years ago my insurance charged 60.00 copay, then when the second year rolled around they changed the drug classification from Non Preferred Brand to Specialty Med which shot the price up to 20% of retail. I was able to get samples from my Dr once I hit the coverage gap which was 2 months into the year.
I've never heard of anyone taking this for 18 months except in the clinical trials; all I've heard of is 24 months of tx. Have you read the Cleveland Clinic and Eli Lily pdf (above) on this?? They are both informative, and definitely worth the read.
Good Luck...
I'm really sad to say that it looks like the Cleveland Clinic is no longer offering their wonderful pdf on forteo. I hope it's only a temporary glitch, but we may not be able to access it anymore.
I personally will contact them and ask why they would take away such an important article from us, and if any of you want to join in please do so. It's also possible that they are updating the info on that page-boy I sure hope it's something like that, and that it will be back soon.
We need this wonderful info!!!
Windblown: I clicked on your Cleveland Clinic link and your right it did not take me to the usual page. So I typed Forteo in their search box and it gave a listing of several articles. I clicked the first one and it took me to your posted article. Maybe they have archived it but maybe we can get them to keep it active. I didn't look for a "contact us" but I wanted to let you know the article is still available just takes some searching. Let us know if there is a way to contact them and I will also ask them to keep it available. Thanks, Betty
Thanks Betty I found it. I've got the new link now so I'll post it below.
Here it is if anyone wants to update this info in their bookmarks. I for one, don't want to loose this.
http://www.ccjm.org/content/70/7/585.full.pdf+html?sid=9e07cee4-b325-4378-a f70-e4b2c0b570f2
Hi Norm,
I started Forteo April 08...I live in Australia.. $850 a month here.. no rebate.. applied to Medical fund who said not leading edge technology so wont subsidise me. We can only use it in Australia for max 18 months in a lifetime. Am having 12 months on then depending on result will save the 6 months till older (I turned 60 on 3 Sept. and have -4.9 T score ! so have to use Forteo). Dr doesnt have "sample pens". Aida
I went in yesterday and my Dr. (his assistant) gave me 3 syringes - they expire in Nov of 2009. I asked if I could get some next year too and she said of course - I asked for 3 and got 3. Other Dr. who don't deal with Osteoporosis won't or don't have samples. I found out a travel letter on the Forteo site and it is to be examined by hand and not go through the conveyor belt. I asked specifically why and they said it had something to do with the protein in the Forteo and it could mess with the stability of the product. I don't think they are 100% sure of this as when asking further she gave me a parallel that you never let it freeze and based on that - she related the protein info. She also said they are resigning the pen and the new one should be out in two months - it will be wider and they came up with fewer steps. They are also sending me two more free gel packs - take two extra frozen ones with you and have the stewardess put it in their cold storage food containers and then exhange it out when you arrive at your destination. On Alaska they told me they didn't have any freezer type compartments. I wonder if any other people have done this with airlines?
Aida: That's too bad that the Dr.'s don't have the pens to give out. However, what to they do when they prescribe it and the patient is suppose to get the first months pen free? Just wondered.
hoffazio: I'm glad you didn't have any trouble getting the pens. At least you know when you fall into the coverage gap next year the Dr's office will help you out by giving you 3 months worth of Forteo-that's great.
I know sometimes on TV the drug companies say they can help those who cannot pay, I wonder if the Lily company would do that for you?
Hi! chapsue, Yes, most of the major drug companies will help those who cannot pay. You can check it out at Lily's website if you are interested in one of their drugs or you can go to the website of Partnership for Prescription Assistance at http://www.pparx.org
You look up whatever drug you are interested in, and the site will let you know if the company that distributes it has a program for prescription assistance. It's easy to use.
Add to the discussion