I may be in your boat now
Hi Wendy,
I have Medicare part D so I assumed that, after payment of the deductible, doughnut hole and other costs so that I had spent $3850 of my own money, that future meds would be 5% of their cost. My insurer, Humana, just sent me a letter saying that, even though Exjade was in their formulary, they couldn't approve me for the dosage my doctor recommended. The norm, according to Novartis, is 20mg per kg of body weight. I weigh about 68 kg, so the dose would be 1360mg. My doc prescribed 1500mg. (According to a recent paper presented at the ASH, the norm is 20-30mg per kg.) The company said they could only approve 500mg per month because that is the Medicare guideline. They said I could appeal and my doc sent a letter. They rejected it saying they need more info. We're not done with the process yet, but I find the whole idea of approving an ineffective dose to be out of medical fantasy land. I'll keep you posted.
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Steve Kessler,Age 71, Dx 3/2001, Currently AML converted from MDS, 5q-, 11q23, Negative response to Aranesp, Revlimid. Partial response to Vidaza in the past. On a study using ON1910.NA, counts too low to go to Stanford on schedule.
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