Preventative care?

[JessC]

Hello, I'm new and there is so much good information here! But I'm stumbling through so if you see this and there's a link somewhere that could help, I'll happily take it!

My mother (70) was diagnosed with stage 1B adneocarcinoma (we are very grateful it was caught early and through a heart CT screening that she herself suggested!). She had surgery to remove a mass in her lower lobe. The doctors are saying there are two smaller suspicious nodules that they think could also be cancerous and the plan is to treat them with SBRT now (instead of waiting to see if they might grow and and what rate). They have also suggested that she start Tagrisso - which would be considered preventative...to prevent the tumor that was removed from growing back. 

Our early investigation says that on medicare we would be paying at least a few thousand a month until she hits a deductible and then it would be $900 a month...until the next year when it starts all over! And they recommend she take the drug for two years. 

At our last appointment, the doctors were saying it was ultimately our decision and that there was some indication that the cost of the drug may outweight the benefits in her situation (because we are trying to predict the future and they are saying there's only a chance that that specific type of cancer will come back...there's no guarantee that it would or wouldn't)

I have two questions for the community:

Has anyone been in this type of situation where Tagrisso or a different targeted therapy was recommended preventatively and if so...was there anything that helped your family make the decision of what to do?

And in general, if you are living in the US (and navigating our frustrating insurance system), did you find ways to lower the cost of the drug? (I realize a few thousand is coming down a lot from $15,000 a month sticker price, but that is still so much money!)

Thank you for any help!

 

[Tom Galli]

Jess,

Welcome here. Tagresso is a targeted therapy used to treat those who have adenocarcinoma with a tumor marker expressing EGFR exon 19 deletion and or exon 21 L858R mutations. I'm not sure I've ever heard of the drug being used as a "preventative" treatment. It is however used as an adjuvant therapy (a treatment that enhances the effect of surgery) for those who've had a resected tumor. Perhaps you are using the word preventative to mean adjuvant. Cancer vocabulary is tough! Here is more information on targeted therapy.

I know folks who've contacted AstraZentica and have received discounts for the drug so I'd try that route if you decide to have the treatment.

Why is there a need for adjuvant treatment? Unfortunately, what makes lung cancer dangerous is high frequency of recurrence after successful first treatment. In your mom's case, stage 1B, studies reveal about a 33% recurrence rate. Here is more information on lung cancer recurrence by stage of diagnosis. So there is more than some chance your mom's cancer will come back; there is a 1 in 3 chance it will come back.

In my situation, I had to fight through 4 recurrences after a successful surgery. I was scheduled to receive adjuvant chemotherapy after surgery but surgical complications precluded me from having the adjuvant treatment. I sometimes dwell on what my life would have been like if I had the adjuvant treatment and didn't suffer the recurrences. 

I hope this information helps you decide.

Stay the course.

Tom

[JessC]

Thanks so much for all that helpful information Tom! That definitely puts the need for the drug in a different perspective. Her doctors made it sound like it wasn't necessary, but I'm going to help her do more research with those links. 

[Lisa Haines]

  As another Stage IV patient, I would absolutely want this IF this were my case.    

   As for coverage, does your MOM have a Medicare Part D RX Plan, as that is where this would be covered.  IF Not, she may be eligible for assistance with the drug maker, but if she had Part D, it should be at least partially covered.   She also can enroll, next October which is the next open enrollment period.  But, she may face a penalty for not enrolling when she was first eligible.   I would check into it now, just in case there is anyway she may be eligible through another special enrollment period.  I f she is low income, she may quality for a State Medicaid program that will help too!    Good Luck!

[LUNGevityKristin]

Like others have mentioned, there may be financial assistance out there.  You can call the Lung Cancer HELPLine at 844-360-5864 and they maybe able to give you resources and options for your mom.  Thinking of you both!

 

[Judy M2]

Sorry I am late responding, hope it's not too late. 

@JessC, AZandMe is a financial support program by the manufacturer of Tagrisso. Your mother's oncologist should be able to help you apply. If she qualifies (necessary every year), Astra Zeneca would pick up the entire cost. Good luck and again sorry for missing your post.