Tecfidera drug coverage with medicare

[rsinger]

Beginning to plan for next year when I start Medicare at 65. How do you get coverage for Tecfidera at that point. I think you need to get private assistance to be able to continue treatment since you no longer get assistance from the drug company once you enroll in Medicare. Always something to plan for.

[kmallory1]

I have Medicare part D for drug coverage. My co-pay for Techfidera is over $2,000 in January every year. February's co-pay is about $1,700. After that, I am through the "donut hole" and into catastrophic coverage, which is 5% of list price, or about $327 per month.

The co-pay assistance from the manufacturer specifically excludes patients on government programs. I do not know of any program to help with costs if you are on Medicare.

[rsinger]

I have Medicare part D for drug coverage. My co-pay for Techfidera is over $2,000 in January every year. February's co-pay is about $1,700. After that, I am through the "donut hole" and into catastrophic coverage, which is 5% of list price, or about $327 per month.

The co-pay assistance from the manufacturer specifically excludes patients on government programs. I do not know of any program to help with costs if you are on Medicare.

I was under the impression that there are private assistance programs that are not affiliated with the manufacturer. That's a lot of money to be laying out of pocket. I will check with Biogen.

[penkalet]

There are copayment assistance programs that do help people on Medicare. Contacting Biogen would a good place to start, or your Doctor.
Good luck.

[rsinger]

There are copayment assistance programs that do help people on Medicare. Contacting Biogen would a good place to start, or your Doctor.
Good luck.

I am calling Biogen today. I pretty sure most people can't afford to pay 8,000.00 copay per year for this medication. It's incredible to me how much this medication cost.

[jessiesmom]

Co-Pay Assistance Resources

I have been taking Tecfidera and in the not too distant future will be eligible for Medicare so this topic was interesting to me. The NMSS website lists the following resources for co-pay assistance other than pharmaceutical companies:

1. The Assistance Fund
2. Good Days by CDF
3. HealthWell Fund
4. Patient Advocate Foundation Co-Pay Relief Program
5. Patient Access Network Foundation (PAN)

Hope this gives you a place to start.You can find the phone numbers on the NMSS website.

[rsinger]

I have been taking Tecfidera and in the not too distant future will be eligible for Medicare so this topic was interesting to me. The NMSS website lists the following resources for co-pay assistance other than pharmaceutical companies:

1. The Assistance Fund
2. Good Days by CDF
3. HealthWell Fund
4. Patient Advocate Foundation Co-Pay Relief Program
5. Patient Access Network Foundation (PAN)

Hope this gives you a place to start.You can find the phone numbers on the NMSS website.

Thank you so much. This is what I have also found. Biogen claims they have our best interesting in mind. No one should go without their medication because of financial reasons.

[robert152]

Rsinger, I believe you can get help paying for your drugs,

Somebody else listed the different organizations that help but in addition you should talk to the drug mfg. In our case my wife is on copaxone and Tevas "shared solutions" is very helpful in a variety of ways. When on medicare you are in and out of the donut hole in 6 weeks and then you are responsible for 5% of the cost which is still a very tidy sum, in your case close to $400.00 a month. The mfg of of tecfidera does not want to lose you because you cannot afford the $400.00. Don't forget they will receive 95% of their inflated cost from the government so they will be very motivated to assist you. I suggest you call them and explain the situation to them and be very honest and if you cannot afford the initial cost of the drug as well as the 5% tell them as they have a solution for you. I suggest you call all the agencies somebody else listed and then tecfidera as a last resort. I believe you will find they have established their own foundation to assist you.

Good luck

[rsinger]

Tecfidera and medicare coverage

Thank you all so much for responding to my concern. I know that so many people are faced with this dilemma everyday. It does seem that the manufacturers are very willing to assist us through this process. I'm planning ahead for medicare so that I will be prepared. I'm sure it will work out. Once you fine a medication that works and you are comfortable taking it you shouldn't have to give it up because of the cost.

Thanks again
Such a wonderful site to be a part of.

[Luvmyfamily]

Any recent experience with cost of Tecfidera when on Medicare?

I see that most of the information of this thread is pretty old. I have been on my husband's work insurance since becoming disabled 7 years ago. Due to his extreme neck and back pain, he is considering retiring - he has worked for the State of Wa for 30 yrs. His biggest hesitation is being able to afford Tecfidera when I switch to Medicare. I would like to know if these assistance programs are helping with the ridiculous cost to the patient after Medicare Part D has paid its share. Any comments about this would be appreciated.