insurance denying Erbitux for stage 3

Kathleen808
Kathleen808 Member Posts: 2,342 Member
edited March 2014 in Colorectal Cancer #1
Hi All,
Well we thought that **** would start Folfox and Erbitux on Tues. However, our insurance is saying no Erbitux for stage III. So, we have to wait to see if he gets randomized out for the study. That delays chemo for another week. For those of you who had Erbitux for stage III was it a pain with your insurance? If so, what did you do?
Aloha,
Kathleen

Comments

  • pamalama
    pamalama Member Posts: 27
    #2
    erbitux
    Kathleen,

    Hi I am sending you a message with some additional information about this. Hang in there and keep trying with them.


    Pam
  • Faith88
    Faith88 Member Posts: 55
    #3
    why erbitux AND folfox?
    Hi I was just curious why both chemos? My hubby had Stage 3 and was on Folfox which is a combo of drugs - but not Erbitux. I was just wondering why that was added? it seems like overkill but of course I don't know the whole story, so there must have been a reason.
    Anyway, I wish you luck with insurance! Boy have I been there done that! I could tell you stories...but eventually you will prevail, just keep after them!
    Faith88
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #4
    Erbitux
    I have stage IV and have been on Erbitux for about 3 years and at first my insurance gave me a hard time. I contacted a patient advocate at my hospital and somehow they got it approved. Sorry I don't have more details
  • kimby
    kimby Member Posts: 797
    #5
    Erbitux
    Kathleen,

    It is my understanding the Erbitux is FDA approved for stage iv crc, but not stage III. I don't have the documentation so please know this is just what I've heard. Insurance would be saying it is experimental and therefore not covered.

    HTH,

    Kimby
  • kimby
    kimby Member Posts: 797
    #6
    Faith88 said:

    why erbitux AND folfox?
    Hi I was just curious why both chemos? My hubby had Stage 3 and was on Folfox which is a combo of drugs - but not Erbitux. I was just wondering why that was added? it seems like overkill but of course I don't know the whole story, so there must have been a reason.
    Anyway, I wish you luck with insurance! Boy have I been there done that! I could tell you stories...but eventually you will prevail, just keep after them!
    Faith88

    Erbitux and Folfox
    Faith,

    Erbitux and Avastin are not technically chemotherapy drugs. They are used in combination with folfox or folfiri and block bloodflow to the tumors, choking them out.

    Kimby
  • pf78248
    pf78248 Member Posts: 209
    #7
    Erbitux and insurance
    My husband was initially diagnosed stage III last year and had Erbitux as part of a clinical trial. Once the oncologist's office submitted it to our insurance company by mistake because it was paid for as part of the clinical trial. Our insurance company did approve it for payent, however. I do know it isn't part of the normal stage III treatment. Turns out he had the KRAS mutation and it was stopped after about six infusions. Good luck, Kathleen. I wish you and **** the best. I hope he gets randomized for the study. Seems like everyone has different experiences with their insurance companies.

    Prayers and best wishes,
    Priscilla
  • Kathleen808
    Kathleen808 Member Posts: 2,342 Member
    #8
    thanks
    Hi,
    Thanks for the info everyone. You're right, it is OK'd for Stage IV and not stage III. I didn't know if some insurance will cover it anyway. I asked Dr. Lenz (USC) and our oncologist in Hawaii and they both said scientifically it makes sense that Erbitux should help prevent tumors but they both said that was the point of the study to confirm it.
    So, **** will be randomized to see if he is in the Erbitux study next week and he should start folfox + Erbitux or just folfox the following week. Thanks for all you support.
    Aloha,
    Kathleen
  • angelsbaby
    angelsbaby Member Posts: 1,165 Member
    #9
    Kathleen808 said:

    thanks
    Hi,
    Thanks for the info everyone. You're right, it is OK'd for Stage IV and not stage III. I didn't know if some insurance will cover it anyway. I asked Dr. Lenz (USC) and our oncologist in Hawaii and they both said scientifically it makes sense that Erbitux should help prevent tumors but they both said that was the point of the study to confirm it.
    So, **** will be randomized to see if he is in the Erbitux study next week and he should start folfox + Erbitux or just folfox the following week. Thanks for all you support.
    Aloha,
    Kathleen

    ERBITUX
    BE CAREFUL SOMETIMES IT MAKE THEM GROW AND SOME TUMORS DON'T RESPOND TO THAT DRUG, TOO LATE FOR MY HUSBAND JUST DO THE RESEARCH ON THAT DRUG

    MICHELLE
  • Kathleen808
    Kathleen808 Member Posts: 2,342 Member
    #10
    angelsbaby said:

    ERBITUX
    BE CAREFUL SOMETIMES IT MAKE THEM GROW AND SOME TUMORS DON'T RESPOND TO THAT DRUG, TOO LATE FOR MY HUSBAND JUST DO THE RESEARCH ON THAT DRUG

    MICHELLE

    hi
    HI Michelle,
    I have been thinking about you a lot. Thinking and praying for you.
    Are there articles on Erbitux causing more growth? Thanks.
    Kathleen

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