August has been the month from hell… Not only are temperatures around the globe breaking records, but my hot flashes are setting some new ones and so are my moods…
Zejula is my cancer maintenance medication. Its other fancy name is Niraparib Tosylate. I started taking it and then my cancer team took me off of it for a week or so because my blood work wasn’t quite right, but after restarting it, my body seemed to be adjusting to it quite well. The side effects are manageable. This drug is a parp inhibitor, which is a new kind of cancer drug that targets my particular cancer cells.
So, I go to refill my prescription on the specialty pharmacy website and get to the checkout area and my copay is ridiculous (like there’s nobody can afford that kind of ridiculous), so I pause and call the pharmacy and they have me call my insurance and they tell me they don’t cover that medicine, even though they had covered it in July. So, I call the doctors office not knowing quite what to do.
Two weeks of phone calls and paperwork, and I still don’t know exactly what went wrong with my insurance… Was it because the manufacturer stopped making capsules and replaced them with tablets? Was it because my oncologist prescribed the first round and my PA prescribed the second? Was it because the pharmacy was trying to mail it from out of state (they do have an in state location)? Was it because the exact right form wasn’t submitted to the insurance company? I may never know…
Our health care system is broken (blog post for another time), but I’ve been super lucky this year with how much of my care was covered… But getting this drug, this life-saving, hopefully curative drug, has just been maddening. Not to mention stressful. Aren’t you supposed to keep cancer patients from being stressed out?
Anyway, I ran out of pills in the meantime and my treatment was interrupted for about a week. My oncologist didn’t seem too worried about it, so I’m trying not to worry… Wish me luck with that.
The good news is that the two weeks of phone calls and paperwork paid off and my insurance is now covering part of the drug. My copay is still ridiculous, but I also applied for a copay assistance program that the manufacturer has in place, because they know how expensive it is. So, I’m covered… For now…
And I finally received a bottle of pills on Tuesday and for that I am very grateful.
Fight for what you need!
