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Xeloda and Humana

marzz26
Posts: 27
Joined: Dec 2007

Hi all and Happy New Year.

I am beside myself as I just found out that Humana has changed the classification of Xeloda from a Class 2 to Class 4. This means that my co-pay for one cycle has gone from $35 to $450!!! What I don't get is that they did not notify me or my onc when I began treatment about 3 weeks ago. The prescription was actually processed 2 weeks before then. Of course, my onc is on vacation and I am, so far, unable to speak with him. I am waiting to hear from another onc in the group.

I am so upset about this... money is tight... do I find a way to pay this (that's $450 every 2-week cycle for about 5.5 months) or do I tell my onc to put me on something else???

If any of you have gone through this, please share.

Marc

AuthorUnknown
Posts: 1560
Joined: May 2006

marc,

I am so sorry to hear of your problem with co-pays. I do not know what to suggest. Perhaps your onc could contact maker of Xeloda to see if there is a program to help with the cost. You could go directly to their web site as well.

My DH has just completed Xeloda and we were lucky enough to have most of the cost paid by ins. Our onc noted how good our insurance was about the cost.

My DH would have to take breaks while on this med so he did not buy all the cycles as was outlined in the beginning. He was not even able to complete the last perscription. His CEA began to climb and the onc decided to try a different treatment. He is now on Erbitux and Camptscar(sp)

Keep talking to the insurance co the makers of Xeloda, I pray they give you a break. The onc usually have someone in their office who is an expert in these areas. Use all your resources.

Good luck and I hope you do well with this drug.

Also, make sure to keep your hands and feet lubricated. DH had the hand and foot syndrone. It was very painful. That was the reason he took breaks from the treatment.

marzz26
Posts: 27
Joined: Dec 2007

Thanks for your reply. I am in contact with Humana, as is my onc's office. My onc is trying to get an override.

By the way, what does DH stand for?

Marc

AuthorUnknown
Posts: 1560
Joined: May 2006

I hope you are having success with your insurance company. Just keep trying. My DH(dear husband) had 5FU, avastin and several other drugs before trying the Xeloda. He has never losta ll his hair although it did thin with Avastin and/or other drugs but not Xeloda. The hand/foot problem and pain were the only side effects but that was enough.

He has just started taking Eritux last week. So far no major side effects.

hope you are doing well. Keep us posted.

LOUSWIFT
Posts: 372
Joined: Aug 2006

The liquid form of xeloda is 5-fu has humana reclassified this. Although I took xeloda I was told by my onc that the 5-fu was slightly more effective. I took Xeloda and the cost was very bad as was the side-effects. I kept checking the pills for gold filling I think it averaged $1600 to $2400 per month. On a happy note the news reported today they they may have found a genetic cure for colon cancer. Unfortunately I don't know much more yet. We all know how these promise cures are always down the road.

marzz26
Posts: 27
Joined: Dec 2007

Thanks for your reply. I have been told that the side effects from 5-fu are more drastic than those from Xeloda (hair loss, nausea, etc). What is your experience?

rmap59
Posts: 266
Joined: Jun 2007

Hi,
I did not take liquid 5-fu but took xeloda for a total of 12 weeks and the side effects were pretty hard for me. Foot and hand syndrome made my feet burn and peel, my bowels stayed upset most all the time with cramping and dirreah and lots of nausea. So I dont know if xeloda is better or not as far as the side effects. I did not lose my hair but would have traded the hair loss for the bowel problems. Anyway good luck to you and I would appeal my insurance company sometimes if you fuss a little they will come around.
Robin

LOUSWIFT
Posts: 372
Joined: Aug 2006

5-fu may have more drastic side effects but I don't know how. I did not lose my hair with Xeloda but the hand and foot syndrome was severe. I took 5000mg each day and by cycle #4 I wanted to quit; die; or both. My feet were the worst. I lost some toe nails; my skin cracked open and did swell and bleed. There were times when for no apparent reason sudden pain felt like a knife was pushed through my foot for 2-3 minutes due to nerves in my feet. When this occurs at night sleeping to out of the question. Most of the time walking felt like there was broken glass everywhere I stepped. My hands did not lose any nails and the bleeding was mostly limited to a few of the fingers. The fingers became really sensitive to touching anything even with gloves on all the time. Buttoning a shirt or tying a shoe lace nearly impossible. Now 18 months after Xeloda I occasionally get the stabbing pain in one foot but it lasts only about 10-30 seconds and does get your attension. Three of my fingers are somewhat numb. Apparently these little bonus effects are permanent. The bowel problems and physical weakness I can't atach to Xeloda but I'm sure it did not help. Still it appears to be effective and perhaps that why the price is so high. Further there is no need for a port which can bring its own set of problems. You might try contacting the drug company directly maybe they could put you onto a program. I still have about 15 pills left but am prohibited by law to give them to someone else. So about $300 dollars worth of Xeloda is on the road to expiration....makes real sense.

hopefulone
Posts: 1048
Joined: Jan 2007

Hi. I'm sorry, it's a real problem on the insurance copay issue and I urge you to keep pursuing options. My husband was on clinical trial with xeloda, but he was also on avastin and oxal on the trial as part of it, so Roche footed the bill for the Xeloda. Not sure if you are having any other chemo regimen, but if so check into it.

ALso, everyone is different with side effects and results. He was blessed and extrememly fortunate to have great results. ( had liver mets and the regimen shrank them considerably to allow for resection - you can read previous posts) and also very few side effects. He did not get the hand foot syndrome that many do. He used cream nightly and I think they may have helped . Also he drank a LOT of fluid to flush his system . I can only tell you based on our experience, but he had no nausea, loss of hair, etc and completed 9 very aggressive cycles. Good luck and God Bless.
Diane

jsabol's picture
jsabol
Posts: 1156
Joined: Dec 2003

Hi Marc, The last thing you should have to worry about is co-pays, particularly given drug company profits. I was on 5FU four years ago; Xeloda was not available. My onc actually called it "chemo lite"! My side effects were very tolerable; loss of appetite, NO nausea, much fatigue, and some loose stools, well managed with a dose or two of lomotil. My hair on my head thinned, and I lost lots of body hair....eye lashes included, but my hair grew back curly at first and thicker than ever. My most serious problem was not getting my first infusions through a port; my viens got really inflamed and painful. The port did the trick. If the choice is between an exorbitant co-pay and infusions, my experience makes the infusions worth a try.
Good luck; stay strong and focused. Judy

kmygil
Posts: 881
Joined: Feb 2007

Hi Marc,
I am so sorry about the insurance woes. You may be able to appeal this as you have a life threatening disease, or there may be some financial help available through advocate groups in your area.
As to the 5FU vs Xeloda, I did Folfox which is 5FU, oxaliplatin and leucovorin. I had rather a lot of nausea, but no hair loss. I did have (and still have) neuropathy from the oxaliplatin, but I think it was well worth it to get to NED. You will have to speak with your onc. to see if he recommends that instead of Xeloda.
Another thing you can try is contacting your state's insurance commissioner to see if his or her office can help with this. Of course, that will take time and you don't have time to waste. However, I had an insurance issue, contacted my insurance commissioner's office, and within 3 weeks the insurance company complied with their dictum. Love it.
Take care of yourself and keep the faith. Hugs,
Kirsten

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