Inlyta Prescription Drug

Jul 22, 2015

  1. axeman462
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    axeman462 Guru

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    Anyone ever come across this drug? it is a crazy expensive cancer drug, costs something like $6,000/mo

    Have a client who is t65 in October, takes the drug. doesn't qualify for medicaid or extra help, and wont be able to afford it when he goes on Medicare.

    Any help, or suggestions?
     
  2. sman
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    sman Guru

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    Have they checked with their Patient Assistance Program?

    PAP for inlyta - NeedyMeds
     
    sman, Jul 22, 2015
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  3. DS4
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    I believe Inlyta is self admin'd. Therefore, covered under Part D. Your client will blow through the donut hole quickly.
     
    DS4, Jul 22, 2015
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  4. kgmom219
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    kgmom219 What's Next?

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    Just because its self administered, doesn't make it Part D.

    Oral cancer drugs: Medicare helps pay for some oral cancer drugs you take by mouth if the same drug is available in injectable form or is a prodrug of the injectable drug. As new oral anti-cancer drugs become available, Part B may cover them.

    Outpatient prescription drugs limited coverage | Medicare.gov

    I just found this out with a cancer client when trying to figure out where her chemo drug was covered.

    Unfortunately, Inlyta isn't on the list.

    Patient Assitance. And call the pharmacy and/or oncology where he is receiving the meds or RX. They may have some ideas.
     
    kgmom219, Jul 22, 2015
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  5. DS4
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    I agree.

    "Sometimes, people with Medicare need “self-administered drugs” while in hospital outpatient settings. “Self-administered drugs” are drugs you would normally take on your own. Part B generally doesn’t pay for self-administered drugs unless they are required for the hospital outpatient services you’re getting. If you get self-administered drugs that aren’t covered by Medicare Part B while in a hospital outpatient setting, the hospital may bill you for the drug. However, if you are enrolled in a Medicare drug plan (Part D), these drugs may be covered"
     
    DS4, Jul 22, 2015
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