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The VA Pharmacy and Zytiga...

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Posted 11/10/2016 3:53 PM (GMT 0)
Have any of you Veterans been prescribed Zytiga or Xtandi through the VA hospital system? I checked their Formulary and these two drugs are not listed but sometimes that's not the final word...Getting answers from the VA over the phone is quite a challenge....
Posted 11/10/2016 4:43 PM (GMT 0)
I have no experience with the VA for Zytiga, but I was surprised that Aetna approved my Zytiga so easily. Especially since it was prescribed as part of my regular HT (along with Lupron and Casodex), which I believe made the use "off label."

Not sure if that success is at all transferable to the VA...
Posted 11/10/2016 5:12 PM (GMT 0)
was told by the VA Clinic that I would have to go to the VA for treatment to receive Zytiga from them. The Hospital is just too far away for me to do that.
Michael
Posted 11/10/2016 5:38 PM (GMT 0)
YES ! I just was able to connect with a VA pharmacist and abiraterone acetate (Zytiga) IS available through the VA pharmacy but only after one of their medical oncologists approves it and writes the script..Refills are done by mail and that part seems pretty straightforward. I am an Honorably Discharged Air Force veteran, 4 years service time, no service related injuries or disabilities. My income level makes me a level 5 VA patient, eligible for most services and prescription drugs are one of the benefits bestowed, after you jump through the hoops....I'll let you know how this all plays out...Through the VA, Zytiga will cost me $84 a year compared to Medicare Part D with its wonderful doughnut hole would have cost me over $8000 a year out of pocket...Last year, the PAN foundation covered those co-pays but that assistance has been withdrawn..I'll let you know when the fat lady sings, I see a VA doctor this Wednesday..

Post Edited (Fairwind) : 11/11/2016 10:28:49 AM (GMT-7)

Posted 11/15/2016 5:02 PM (GMT 0)
There is a program, if I recall correctly, called V.A. Choice. If you live more than 20 miles from a V.A. hospital you can be approved to see a doctor of your choice for your condition, and if it is service related the V.A. Will cover the fees and medications. This is something you will want to check on the VA site or booklet describing the Code of Federal Regulations.

Otherwise, if the VA medical oncologist agrees with the Perscription your doctor writes they will fill it for you. That includes Xtandi and Zytiga. However, keep in mind the VA doctor has the ultimate authority on wheather the VA honors the Perscription.

This information is in Chapter 6 Coordination of Care.
It states: " If you need or choose to receive treatment from private doctors, we will work with them to meet your health care needs and coordinate effective treatment. We call this Co-managed Care or Dual Care- which means that your VA and private doctors will work together to provide safe, appropriate, and ethical medical care."

Hope that helps.

Regards,
Rick
Posted 11/15/2016 5:46 PM (GMT 0)
RicktheRock has pretty much summed it up. Here's some additional information on the Choice program from the VA website:

www.va.gov/HEALTH/NewsFeatures/2015/July/10-Things-to-Know-about-Choice-Program.asp

(You may have to copy and paste this link to your browser in order to retrieve it, as I can't get the link to work on a direct click).
Posted 11/16/2016 2:20 AM (GMT 0)
"However, keep in mind the VA doctor has the ultimate authority on wheather the VA honors the Prescription."

I am VERY well aware of this..I see my VA PCP tomorrow (first visit) and hopefully she will refer me to a Oncologist who, hopefully, will write the script...It's just a matter of jumping through the hoops and getting lucky...Wish me luck....I am based in Denver at the moment, there are several major VA facilities a short distance from where I live. I walked in the door and said here I am and was seen quickly and treated very professionally and all my questions answered. The VA has come a long ways..
Posted 11/16/2016 2:29 AM (GMT 0)
C'mon Fairwind:

What's a few 10 thou among friends!?

Mel
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