Erbitux and Insurance companies

PhillieG
PhillieG Member Posts: 4,866 Member
edited March 2014 in Colorectal Cancer #1
Hi Semi-Colons. I have found out that I have some mets to my lungs. My oncologist wants to put me on Erbitux and CPT11. She was saying that some insurance companies do not want to pay for the drug (even though it IS approved by the FDA for colon cancer) Right now, I had my Onc send in a letter of 'predetermination' as they requested, and it is being fast tracked through the system so hopefully I will know in a day or two if they are paying for it. Has anyone out there had any experience with this? I know the Erbitux can cause major pimples, but I've heard that it works too.
Thanks,
-Phil

Comments

  • nanuk
    nanuk Member Posts: 1,358 Member
    #2
    The stats on these drugs are confusing-you might try googling them, or word searching on this site..
    I'd be interested to know the rest of the story..
    This post points to a need for a central site here to go for some of these answers..huh, Jose..? Nanuk
  • CAMaura
    CAMaura Member Posts: 719 Member
    #3
    Hi Phil,
    I don't have any first-hand experience with Erbitux/insurance issues. But my sister-in-law is part of a clinical trial using it. If you run into problems, you might try that avenue. I have to say that she is pleased with few side effects. She does have the skin rash, but feels good and has a lot of energy.
    Best of luck to you.
    Cheers,
    Maura
  • Unknown
    Unknown
    #4
    nanuk said:

    The stats on these drugs are confusing-you might try googling them, or word searching on this site..
    I'd be interested to know the rest of the story..
    This post points to a need for a central site here to go for some of these answers..huh, Jose..? Nanuk

    This comment has been removed by the Moderator
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #5
    A Blast from the Past
    This was my second post on this site. The first one had a broken link in it. I think this still might be an issue on whether Erbitux is covered by insurance or not. This dates back to July 4th, 2005.
    So that's how long I've been successful with Erbitux if anyone needs this info.
    -p
  • msccolon
    msccolon Member Posts: 1,917 Member
    #6
    PhillieG said:

    A Blast from the Past
    This was my second post on this site. The first one had a broken link in it. I think this still might be an issue on whether Erbitux is covered by insurance or not. This dates back to July 4th, 2005.
    So that's how long I've been successful with Erbitux if anyone needs this info.
    -p

    and you haven't changed a bit in almost 4 years!
    ;)
    mary
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #7
    CAMaura said:

    Hi Phil,
    I don't have any first-hand experience with Erbitux/insurance issues. But my sister-in-law is part of a clinical trial using it. If you run into problems, you might try that avenue. I have to say that she is pleased with few side effects. She does have the skin rash, but feels good and has a lot of energy.
    Best of luck to you.
    Cheers,
    Maura

    My 2nd post ever! Erbitux and Insurance companies
    Thanks you Folks. I will most likely be going in to NYC on Wednesday to start this chemo. I should know today about the insurance coverage. I don't get what the issue is myself. It is an FDA approved drug. I am part of a clinical trial (for my hepatic pump) and the stuff works. It's like seeing if I'm 'sponge worthy'. I'll let you know what happens.
    Phil
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #8
    msccolon said:

    and you haven't changed a bit in almost 4 years!
    ;)
    mary

    True
    thanks to the magic of having the photo update every post ever...
    That was well over 3 years ago, I joined May 25, 2005 so I am close to 4 years on the forum.
    And they STILL haven't thrown me off!!!!
    What's wrong with these people, I would have banned me by now :-)

    Hope you are feeling well Mary
    -p
  • spongebob
    spongebob Member Posts: 2,565 Member
    #9
    KIND OF FREAKED ME OUT THERE, PHIL
    Seeing Nanuk "responding" to you...

    Anyway, I hope that your insurance company will cover your erbitux & your CPT11 treatments. Not to kick a dead horse, but THIS is what I mean about how the insurance system is broken. Imagine it; a system where some pencil pushing prarie-dog-town-dweller has the power to say yes or no to life-giving treatment that is approved by the freakin' FDA! Amazing. NO, I'm definitely NOT trying to get that thread started again - I think in the final analysis of that we're all on the same side, we just see different (well stated) options for how to get there.

    When (not if!) you start your erbitux, you should give a call to Jessica Simpson and see if you can use some of her endorsed acne medicine. YOU might have a great future in TV endorsements, Phil!

    Be well

    - SB
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #10
    spongebob said:

    KIND OF FREAKED ME OUT THERE, PHIL
    Seeing Nanuk "responding" to you...

    Anyway, I hope that your insurance company will cover your erbitux & your CPT11 treatments. Not to kick a dead horse, but THIS is what I mean about how the insurance system is broken. Imagine it; a system where some pencil pushing prarie-dog-town-dweller has the power to say yes or no to life-giving treatment that is approved by the freakin' FDA! Amazing. NO, I'm definitely NOT trying to get that thread started again - I think in the final analysis of that we're all on the same side, we just see different (well stated) options for how to get there.

    When (not if!) you start your erbitux, you should give a call to Jessica Simpson and see if you can use some of her endorsed acne medicine. YOU might have a great future in TV endorsements, Phil!

    Be well

    - SB

    A Blast from the Past
    That was along time ago. I knew people at Sloan who help me expedite it. I've been on Erbitux steadily since that post. I basically had SK tell my insurance, it's this or I'm dead.
    Needless to say I got it but what a PITA. The acne isn't too bad. It's the splitting fingers that get me but I started trying paraffin last night and so far it seems like it's not hurting and I may be on to something. Time will tell. I find it runs it's cycle though. I have treatment, get the rash, it goes away in a few days, I look fine, I get treatment get the rash, it goes away in a few days, I look fine... for almost 4 years.
    I agree, it should not be up to some "pencil pushing prairie-dog-town-dweller" (too f-ing funny) person to decide my fate. I mainly got a kick out of seeing my post from sooo long ago.

    Happy Easter/Good Friday/Passover/Festivus/Whatever, to everyone.
    Be well.
    -phil
    you look sharp there SB in your uniform.
    I'm going to try to spectate and not still the pot too much for a while, it's tiring :-)
    I think my first post was something that was controversial. It's in my genes/jeans.
  • spongebob
    spongebob Member Posts: 2,565 Member
    #11
    PhillieG said:

    A Blast from the Past
    That was along time ago. I knew people at Sloan who help me expedite it. I've been on Erbitux steadily since that post. I basically had SK tell my insurance, it's this or I'm dead.
    Needless to say I got it but what a PITA. The acne isn't too bad. It's the splitting fingers that get me but I started trying paraffin last night and so far it seems like it's not hurting and I may be on to something. Time will tell. I find it runs it's cycle though. I have treatment, get the rash, it goes away in a few days, I look fine, I get treatment get the rash, it goes away in a few days, I look fine... for almost 4 years.
    I agree, it should not be up to some "pencil pushing prairie-dog-town-dweller" (too f-ing funny) person to decide my fate. I mainly got a kick out of seeing my post from sooo long ago.

    Happy Easter/Good Friday/Passover/Festivus/Whatever, to everyone.
    Be well.
    -phil
    you look sharp there SB in your uniform.
    I'm going to try to spectate and not still the pot too much for a while, it's tiring :-)
    I think my first post was something that was controversial. It's in my genes/jeans.

    HAPPY WEEKEND!
    Glad you got your meds - I'm really bad about checking the date on posts unless I see a blast from the past.

    You have a great weekend - as far as I'm concerned, any day that I wake up on the green side of the grass it's a holiday!

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