Its early Monday morning, so let’s get started. We will focus on programs for patients living in the U.S. first. Wednesday, we will take a look at how Canadian patients deal with similar financial hardships.
Here are the basics. I don’t have to tell you how expensive living with multiple myeloma can be. I recently learned I needed a stem cell transplant (SCT), because my myeloma had become active and destructive again.
Fortunately, my wife, Pattie, has excellent insurance through her work. The group provider, Cigna, just pre-approved paying for my transplant. My case worker told me the average cost for a SCT–including pre-testing, the procedure and six months of follow-up care–is $300,000.
Of course, Cigna doesn’t pay that much. The company negotiates lower rates and will probably pay-out closer to half that amount. That’s still over $150,000!
My maintenance therapy drug, Revlimid, costs $7,000 or more a month. That’s each and every month!
Add the costs of diagnostics like blood work, x-rays, MRI’s and PET scans and… Well, it costs a lot!
The good news is many of us are living longer. The bad news… It costs a lot!
Let’s focus on another piece of good news: There is financial assistance available for most multiple myeloma patients.
Most assistance programs focus on co-pays. They assume you have Medicare and/or some other type of insurance. So these programs help you pay for the out-of-pocket expenses you are left with after insurance pays most of the bill.
The Leukemia & Lymphoma Society (LLS) provides up to $10,000 a year of co-pay assistance.
The Chronic Disease Fund’s “Good Days” program is more comprehensive, but can be a bit more difficult to qualify for.
Speaking of qualifying…
Programs like the two I mentioned above require proof of financial need. For example, the LLS program approves patients who’s income doesn’t exceed a certain amount–around $80,000 a year.
You will be required to produce tax returns and other financial information in order to qualify. Same for the Chronic Disease fund.
If you and/or your spouse aren’t working, or you are on social security, you may qualify for major assistance from the drug companies themselves.
Since Revlimid is an oral chemotherapy medication, it isn’t covered by Medicare Part B like Velcade is. That can get really expensive, even if you have some type of drug plan.
So Celgene, the makers of Revlimid and Thalomid, offer a patient assistance program to help pay for your chemo if you can’t afford to. But let me warn you: Celgene has very tough requirements in order to qualify.
However, even if you don’t, the company will often provide you with a month’s worth of medication while you fight with your insurance company before they eventually approve you.
That’s enough for today. I have been getting some great email suggestions for sources of financial aid. Keep those coming! Tomorrow I will provide you links to some additional, less well know sources of funding.
Feel good and keep smiling! Pat