Ibrance--Pfizer patient assistance

Hi everyone, I'm writing to share our experience with the Pfizer patient assistance/oncology together program.  My mom was prescribed Ibrance for her recurrent MMMT based on the genomic testing results (CCND1 amplification, which may be targeted by Ibrance).  Ibrance is not FDA approved for uterine cancer (just breast cancer I think right now).  But there have been trials showing it is effective when paired with an estrogen inhibitor.

Her insurance (Medicare drug supplement) denied coverage because it is not FDA approved.  They refused to budge after appeals.  No surprise, this drug is outrageously expensive if paid 100% out of pocket.  So we applied for assistance through Pfizer.  The process was pretty easy (forms for her and the doctor to complete and fax back).  I did need to follow-up to get it processed though, so if anyone tries this I don't suggest waiting to hear from them.  Pfizer approved the application and is providing the drug entirely for free.  I was very surprised but the represenative told me the only reason she sees requests denied is if the applicant is over the income limit (you need to be under 400% of poverty level). My parents are retired so they fell in the right group.  There is also co-pay assistance for those with insurance coverage, I do not know if the income requirements are different.

I took a look at the list and there are many other oncology drugs that can be provided under the program.  I wanted to create a new post in case anyone needs this now or in the future. It makes me sad that $$ is something we need to think about on top of everything else, but that is the reality in the US, at least right now.

Thanks everyone!

Anne-Marie

Comments

  • TeddyandBears_Mom
    TeddyandBears_Mom Member Posts: 1,814 Member
    Thanks for the information

    Thanks for the information Anne-Marie. I go on Medicare next April and am still a bit apprehensive about it. There have been several posts over the last few years about Medicare that I have saved for reference in choosing my coverage. It is very helpful to get pointers from people that have been there, done that.  Your post will go into that saved file for that 'just in case' time.

    Love and Hugs,

    Cindi

  • cmb
    cmb Member Posts: 1,001 Member
    Thanks

    Thanks for sharing this information. Even when someone has insurance, tryng a drug that hasn't been approved for a specific condition often depends upon these types of programs from the drug manufacturers. Not all such requests have been successful for other women here, so it's always good to hear when the process works for the patient.

    I hope Ibrance works well for your mother.

  • Mercorby
    Mercorby Member Posts: 105 Member

    Hi,

    I am wondering how your mother is doing on Ibrance. I'm still on it for endometrial cancer maintenance - over 5 ½ years now. I still don't know any uterine/endometrial patients on this regimen! They aren't on any of the forums if they are. I have to hang out on the MBC forums which is frustrating. When I switched to Medicare in July,

    I didn't have any issues with my Medicare advantage and Medicare and Pfizer still covers my copay btw.

    Corby

  • NoTimeForCancer
    NoTimeForCancer Member Posts: 3,476 Member

    Anne-Marie, I hope Ibrance is the key to your mother's future. Mercoby I am thrilled to hear you have done so well on it.

    I was on a call somewhere and I remember asking if patients who receive drugs like this, sometimes referred to as compassionate care, are tracked anywhere since it is not a clinial trial and I was told no. Clearly there is a lot to be gained from seeing how these patients respond, but pretty much the only way the FDA will approve drugs for use is if they go through the clinical trial process.