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Xifaxan and Medicare costs

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Posted 3/26/2015 4:58 AM (GMT 0)
Hi everyone,

I know that some of you have gone through this already. Hopefully you can offer some of your knowledge.

I started medicare Feb 1, 2015. I believe the coverage gap is quickly approaching for Xifaxan. I have had the "donut hole" explained to me several times, but I can't seem to wrap my head around it. I've decided that I don't need to understand it, but rather find out how much a 30 day supply of xifaxan cost on medicare (I do have a supplemental plan also).

That's one question. The second is mail order? Is it possible? Does it depend on your secondary insurance company? My partner mentioned possibly getting it from Canada?

I want to make sure the Canada thing isn't illegal? Not into anything like that - just trying (like us all) to save a few dollars where we can.

Any info would be appreciated!

Eyes
Posted 3/26/2015 2:06 PM (GMT 0)
Hi eyes,

I won't go into the formula and math of it all. During the donut hole, themister pays 45% of each $27 tablet. 2 pills per day= $729 for a 30 day supply.

It's tough.


Here is Medicare Part D info:

www.medicare.gov/part-d/costs/coverage-gap/part-d-coverage-gap.html#1306

How are you doing, eyes? Would love an update. Big Hugs
Posted 3/26/2015 6:37 PM (GMT 0)
Thanks Miz for the breakdown. With mild HE, I can function pretty well on a lot of levels - but not at math/numbers!

I'm just hanging out on the wait list like the Mister and many others here. I appreciate you asking. Some days are better than others, and I work really hard at staying compliant. I eat the way they told me to, and added yoga (2 times a week class & other days on my own) about 9 months ago. I was an artist/athlete my entire life up until I was hospitalized/dx, so the yoga fulfills many spots in my life.

I have 3 mo clinics, monthly labs for MELD, hep appts, scans..you know the drill! ;) They seem to have been watching 2 particular "lesions" that I get scanned for pretty frequently. I'm also coming up on a year since a lot of the testing was done, so I'm assuming some of them will be coming due soon (mamo, colono/endo).

I'm very involved in my 12 step program. I have been sober for 2 years, and I am just starting to help others start their own recovery journey. Feels good.

It's not all wonderful - there are bad reaction lactulose days, can't get out of bed days, confused days, and days that my partner's patience is surely stretched to its limit. I'm here though - some days that amazes me...didn't think I would...neither did the drs...

My MELD is between 19-21. It's still a challenge to practice patience in this waiting game. But, I know that our times will come... eventually :)

Eyes
Posted 3/26/2015 10:45 PM (GMT 0)
eyes,

You and themister are on a very similar path right now. So glad to hear you are doing yoga to keep in shape.

Let's hope you are a lucky one with the wait. I think you are at the same tx center as Mama Lama's Mike. Do you know what the MELD for your blood type is at your tx center? Hope you are getting close.

Themister has had a bunch of dry run's. 4, actually. 3 times as back-up, once was his own "the call". You likely read about his crazy experience as it unfolded. Let's hope your experience is not as "interesting". We both learned much in the process, but not here for growth, as it were.

I am so glad you remain sober today. Best news of all, eyes. Good to hear an update on you : ) Big Hugs
Posted 3/26/2015 10:53 PM (GMT 0)
Eyes....I feel for the families who are waiting, waiting, waiting.

I hope with fewer Hep C cases needing transplants the MELD scores may go down to qualify for TP....but not before this "wave" of patients suffers and suffers.

Though Mike's hep doc says that NASH is going to be the next wave with obesity such a growing issue...that could be me...must get wt under control!

My best to all, waiters, treaters, loved ones...

Mama Lama
Posted 3/27/2015 3:23 AM (GMT 0)
Thanks. Yes, TM, we are on a similar path number wise, but I have been extremely lucky with the HE. Much more so than the Mister. My heart always aches for the caretakers who have to go through that. I am listed in the same place, but I'm not sure the MELD range for my blood type. I think I've heard between 22-27. I was keeping up to date while the Mister was going through his marathon runs to the hospital. I was just hoping they would have the right one for him. Exhausting.

ML - I had not thought about the next wave of people- makes sense since it seems kidney disease (whichever type is preventable) is on the rise. I hope Mike's hanging in there. Guess he's pretty busy tomorrow.. Speedy recovery to him, and a restful nights sleep for yourself.

Eyes
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