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Why Oxaliplatin? and cost of Neulasta

SandyL
Posts: 220
Joined: Feb 2009

What does this drug do for the chemo treatment?
Husband gets it every time prior to the 5FU, but I guess I've
forgotten why they give it. And if they can cut the amt.
down for the ones that have terrible side effects, why give
it in the first place?

He has had to have two Neulasta injections. We received the
insurance papers for the first one and were shocked to see that
the bill for that one injection was almost $10,000. One shot!
And he will need one after each treatment. We are so blessed to
have insurance. But is this realistic?

Sandy

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

Sandy... don't get me started on the cost of some of these drugs and how the pharmaceutical companies are in charge and no one has done anything to stop them. I realize a lot of research goes into the creation of drugs, and then there's the long period of testing, fine tuning and re-testing them again. All this takes time and money. But what good are these magic drugs if no one can afford them?? I just don't understand the concept or justification.

What is kind of interesting... if you google the cost of Neulasta, most all websites say the cost is between $3000 - $7000 per syringe. That's a pretty darn big difference in one syringe of medication!! And then your bill said the injection was $10,000... another $3000 on top of the highest estimate. Like I say, the pharmaceutical companies have people by the short and curlies when there is no competing med. There is Neulasta which is a one shot per treatment medication and there's Neupogen, which you have to give yourself up to 10 shots per day. Each Neupogen shot is much cheaper (about $300/injection) but by the time you've given yourself enough to bring up the white blood cell count, you will have spent the same amount of money as the one injection of Neulasta.

When I was getting my treatements, I didn't need the injections, so I have no idea if they are covered by my insurance or not. I'm assuming they are but it's definitely a good idea to find out if your insurance company will cover them before anyone starts their chemo and talk it over with the oncologist in case this ends up being a big problem. The thing is, it's not like you have a choice... if you do the chemo and your cell count drops... then you HAVE to have the shots. Yikes!

As for the Oxaliplatin... this is a chemo that works very well with the chemo 5-FU and the vitamin (for lack of better description) booster, Lecorvin. The oxaliplatin is an anti-tumour chemo, where it breaks attacks the tumour activity. It's always giving in combination with the 5-FU and from what I understand, it can help in boosting the survival rate.

When fighting cancer, depending on which kind of cancer you are fighting, you really do want to use whatever ammunition they have available. The combination of 5-FU and Oxaliplatin are the most common combo for colon cancer. It's like comparing to AIDS treatment. When AIDS was first discovered, all AIDS patients went on AZT... and basically were given 2 years survival from diagnosis. More HIV/AIDS drugs have been created and combos have been put together. The idea is to get the best combo for each patient and nowadays, people are "living with AIDS" not "dying from AIDS" and it's all because of the research into AIDS cocktails/combos that have been found and created. Right now, for colon cancer the combo of Oxaliplatin/5FU/Lecorvin is the best... and with a little bit of luck, many more will be found while we keep our cancers stabilized.

Huggggggs,

Cheryl

polarprincess
Posts: 210
Joined: Aug 2008

Oxaliplatin is given because it has become standard treatment for colon cancer. It increase survuival odds by about 7%, and according to my onc the biggest benefit is for those with the most advanced disease. As far as the dose reductions...the more studies they do, it appears that it is ok to do the reductions to avoid long term side effects without it affecting outcome.. in fact it appears the regimen may be changing in the future to remove it mid treatment and reintroduce later..
As far as the neulasta.. definitely ask whether it is necessary each time. I am on cycle #9 and have only received the shot once. My counts always seem to bounce back just fine. Even if my counts are borderline i will refuse it. I don't understand the reasoning behind automatically scheduling it. Some of the possible severe side effects from the shot are from having too high of a white blood cell count, so adding the shot in when counts are only borderline to me is asking for trouble.....The cost of my 1 neulasta shot was $7,000 but i dose of oxaliplatin was $17,000!!

angelsbaby's picture
angelsbaby
Posts: 1162
Joined: May 2008

The chemo place was giving that also as a precaution in case his white or red cells were low can't remember which one but any way i told them to stop giving it if his blood work was ok. and they did he only got that shot if he was low. it was about 6000 for the shot.I was kind of mad it was like they just wanted the money.

michelle

lisa42's picture
lisa42
Posts: 3663
Joined: Jul 2008

Hi Sandy,

I've also heard the cost of neulasta shots is very high. My Dr. office has most patients taking neupogen shots instead of the neulasta because of the major cost difference. I wish I knew the actual amounts of both to tell you, but I don't. The drag with the neupgen shots is that neulasta is once a week (I think) and the neupogen needs to be taken more often. I only took them one time because I had a weird rare reaction (which seems to be a theme with me- something happens & I'm told "we've never seen that before") anyhow... when I did take the neupogen, I injected myself (which really wasn't bad) and I did it three days in a row following my chemo infusion. Again, I don't know specific cost numbers, but I've heard the neupogen (even with needing a few a week) is much, much less than the neulasta.

Take care,
Lisa

lisa42's picture
lisa42
Posts: 3663
Joined: Jul 2008

Hi again,

As I said above, I had a weird reaction to the neupogen, so I won't be taking them anymore unless absolutely neccessary. Absolutely neccessary in my mind means getting an infection that won't get better when treated. I've not had that happen at all yet- in fact, each time my white count dipped low before, it always came back up on its own. I was mad when they wanted me to take the shots because I argued to give my body a chance to come back up on its own, as it had every time in the past. They won out, I took them, then had the reaction. They now agree w/ me that we'll let my body do its thing and only if it doesn't, will I take the shots again. I think maybe too many Drs and/or nurses jump the gun in wanting patients to take the neulasta or neupogen without giving the patients' bodies a chance in bouncing back a few days later on their own. I'd beg to try to see what your body does on its own first. When bloodwork is done a few days later, you'll know whether you really do need it, or whether you just need a couple of days to bounce back.

Take care!

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

Wanna talk about the fleecing of America..........Its $6000 a pop at my office....The very same Neulasta shot in Canada is $60...isn't that a kick in the butt......

HollyID's picture
HollyID
Posts: 940
Joined: Dec 2009

My neulasta shots were $6000 too. Every two weeks I got them, but I don't recall how much the oxaliplatin was. Definitely not $17,000. More like $2,000.

jsayler's picture
jsayler
Posts: 4
Joined: Apr 2011

I have had so many problems getting the medical people here in Las vegas to understand that not only do I not want to have medications that i don't believe help (lots of the anti-nausea drugs make me very sick as does dexamethasone) since I moved here from Minneapolis. No one here seems to believe me. This is my third time battling the beast. I was diagnosed in 2003 and I have been doing very well. It took some time for my doctor in Minneapolis and I to determine that I was having a bad reaction to many of the designer drugs that are so often pushed on patients.

The medical here has scared me. I have been through so much--even doctors treating me VERY badly for asking questions and trying to negotiate specific treatments (only because I know what works for me). I also simply cannot afford the deductibles or co-pays. We have already lost everything and have just started rebuilding our lives. I just left a doctor who was totally disrepectful and down-right cruel. She even talked about me to the chemo nurses before I went in for treatments. The nurses started treating me so mean that I was nearly in tears every time I went in for my weekly treatments.

If I weren't my best advocate, I doubt that I would still be alive. My doctor before this last one actually said that since I did n't have any visable tumors and my tumor marker was down that he was not going to treat me until I had tumors that were eveident on a PET scan. He referred me to the last doctor who turned out to be the cruelest of all.

Your strength has given me a lift today. Thank you. Some days just don't seem like anything can do that but you did on a day when I received yet another bill I cannot afford to pay.

Joy

SandyL
Posts: 220
Joined: Feb 2009

so, it would seem that he will be ordering it after each treatment. Unless we refuse it. It makes him feel bad for several days after the shot. It has brought his count up. His count was actually lower than the lowest normal reading when he first started the chemo in December.
His count was too low on treatment #5 so it was delayed for a week. When he got the Neulasta the blood count was higher than it was in the very beginning and the treatment was so much smoother with less of the bad side effects, too. So we are now ready for the CT scan that will be tomorrow then next week another treatment. Hopefully it will be an easy one, too.
Thanks for all your comments.

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

You could opt for 2-3 neupagen shots that can be given on weds thurs and Fri before mondays treatment if the count is low. The neulasta will last from the time that the needle comes out of the port until the next treatment so the juggling appts are easier (0 instead of 3). You would just have to go in for 2-3 days in a row and have blood count done and if they are low take the 2 or 3 shots if not see ya Monday...I took one neupagen shot on a friday and was suppose to go to the hospital and get another one saturday and didn't go. My counts on 1 shot were high enough to do the treatments on monday. I took after the 7th treatment Nelasta because my counts dropped after every treatment and I think that the neulasta was easier to schedule ) cause I got them on Weds Needle removal day). Probably the ease was the only reason for them.....

I had a slight headache and very slight lower back pain where the fluid I think is to rebuild the White Blood cells...or where it does all its work at.....usually 2 days and its gone also...Hope this helps some....God Bless ya

Shayenne's picture
Shayenne
Posts: 2370
Joined: Jan 2009

My onc wants me to try just one shot too see what kind of reaction before she orders more, to get my WBC count up, and the only way my insurance will cover it, is if I drive the 2 hours and back again at that center for just a shot! they can put it down as "part of the chemo then". Now, the cancer center did say the local pharmancy would be able to disperse it, where I would have to inject it myself (which would scare me, but I have RN friends who would do it for me), but my insurance won't cover it that way, so now they mentioned that Home Health would also disperse it and give it to me on Saturday, but I'm not sure if insurance would cover them doing it, so we have to call them, to make sure insurance would let them...

But otherwise, I have the feeling we'll have to spend all that gas money driving 2 hours and back for a 2 second injection...insurance companies are just one big runaround.

My onc and the nurse did say there will be some aches and that would be because the bone marrow is working harder to produce those WBC counts, but I hope it's not that bad that a painkiller or some motrin or tylenol should take care of that she said.

msccolon's picture
msccolon
Posts: 1956
Joined: Oct 2004

seems to me I got a shot of neulasta before heading home when I got IV treatment. The Neupogen would go home with me for 3 days, but I know I didn't go back for neulasta shots. Just wondering, 2 hours for a 5 second shot is a bit much!
mary

Shayenne's picture
Shayenne
Posts: 2370
Joined: Jan 2009

... I think they are trying to not give me so much all at one time since I'm recovering from that infection, and they said it had to be after 2 p.m. but by Sunday to get that show, they are timing it specifically somehow, and I think I may have hubby just ask the doctor anyway when she calls back, because he is calling about this stupid insurance not paying for things locally, I hate to drive up there 2 hours for that!

Edited to add: I just asked hubby and he said because I'm still on a fanny pack for 46 hours here, they don't give it the same time on chemo, but it has to be done after my pump is removed or something like that.

SandyL
Posts: 220
Joined: Feb 2009

states 24 hours after the pump is removed. And Donna, I wonder why if the insurance would cover you to give yourself the Neulasta shot-how would they know if you had a RN friend give it to you instead? So the ole "what they don't know, won't hurt them". And yes I totally agree with your assessment on the insurance run around. Husband has some discomfort for two days following the N, but nothing that Aleve won't take care of.

I'm hoping that the reason his last treatment didn't bother him so much is because his wbc was so much higher. Thank you Neulasta for that.
Sandy

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

I got my neulasta shots right after they pulled the needle out on Wednesday and it had my counts back up for two weeks for the next chemo..

mom_2_3's picture
mom_2_3
Posts: 939
Joined: Nov 2008

I get Neupogen shots that I do myself at home. I do them 3 days in a row (wed, thurs and fri) before my Monday treatments. They cost something like $200 (although my insurance pays for it). It is a quick and painless shot to give myself. I just jab the needle in my thigh and it's over. Insurance would pay for me to go get them at the clinic but it's a waste of time to do that when it's so easy to do at home.

The first time I had them I had some pain in my ribs and I needed to take tylenol for that. Every time since that first round I have had no pain or issues.

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