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Excellent video ADT + Zytiga for long term hormone therapy

desperate for hope
Posts: 44
Joined: Oct 2016

The video on the "uro today" website involves two specialists discuss how practice will change since the recent articles in New England Journal of Medicine about prescribing Zytiga/Abiraterone with hormones for men with high risk, node positive or metastatic men on long term hormone therapy. 

A Clinical Conversation with Alicia Morgans and Charles Ryan: Considerations of ASCO 2017 LATITUDE and STAMPEDE

https://www.urotoday.com/categories-media/1748-centers-of-excellence/advanced-prostate-cancer-coe/784-embedded-media2017-06-21-00-48-43.html

GeneRose1's picture
GeneRose1
Posts: 64
Joined: Aug 2016

Thanks for the link and introduction to Uro Today. The core issue that I ran into about combining Zytiga with ADT/HT, like Lupron, is the financial costs. Right now this new treatment has not been approved by the FDA and Medical Insurance companies will not pay for it. Many Medical Oncologists know about this treatment innovation but there's not too many patients who can cover the out-of-pocket costs over the long term. I haven't done any deep research into it but a quick jog through the internet seems to point to a $5,000 per month cost for Zytiga.

slickjy
Posts: 26
Joined: Jan 2017

My Zytiga cost is about $7450 annually: $2500 1st month, $450 each month thereafter.  This is with Part D Medicare drug coverage from SilverScript.  Definitely not cheap, but not as drastic as stated above.  

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3297
Joined: May 2012

slickjy and all others,

I did a five-drug chemotherapy regimen that was put together in the 1980s as the standard against Hodgkins Lymphoma.  I began 6 months of treatments in 2009.  Each treatment contained all 5 drugs, given as a set once every two weeks (an 8 hour infusion day).  Each infusion, just for the five drugs, was around $28,000.   My infusion RN told me one day months after I began that the "sitting fee" for the first hour in the infusion station was $300, and $150 for each hour thereafter. I asked for clarification, and he said that "to come in here and sit down is a $300 charge, which does not include any drug costs."

No doubt some drugs cost more than others, but that is an average of about $5,2000 per individual bag.  Neulasta, given to boost WBC production, which is killed off by the chemo, was a sixth drug that I got separately two days after each infusion. It is delivered as a shot in the belly. Cost per application for the Neulasta was $7,000 each.

My hematologist told my wife and I one day that "these drugs are not new, and the prices are ridiculous."

We were blessed with great insurance, and had to pay only the max amount out-of-pocket of $10,000 in 2009, and then another 10,000 when treatment continued into 2010.  Plus some miscellaneous charges, plus missing work for about a year. My total with doctors, scans, labs included ran to over $450,000.  

A stem cell transplantation (SCT), a technique used against multiple relapses for some Lymphomas and many Leukemias, routinely today costs over $1 million.  Note that SCT does NOT in any way involve embryonic stem cells, and is an intensive set of activities which ordinaily takes  many months to complete.  Patient deaths from the treatment used to run as high as 30%, most from Graft-vs-Host reactions. It is a bit lower today, from improved GvH drugs.  If I were to ever relapse with what I had, it would be necessary to get a SCT.

When I spoke to a radiation oncologist about getting IGRT for PCa in 2015, I mentioned those chemo costs to him.  He was senior R.O. at the same center that I went to for the chemo, and said, "What you saw were the asking costs that are billed to the insurance company. NO one ever pays those amounts, or anything close.  It is all negotiated down from there."  So insurance companies have negotiating power, although out-of-pocket individuals may or may not.   For clarity, I was 53 at the time, and inelidigble for Medicare or Medicade.

My point is only that this stuff is morally obscene in pricing.

max

redbelly7
Posts: 34
Joined: Jul 2017

What really gets me, is that people, (prolly not even paying proper taxes, etc) on crack, opiods, etc can get Methodone for free from the Gov., but people that have worked and paid taxes all their life may make too much money to get financial help for a break through treatment like this.

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