Neulasta - Any advice or tips?

It was covered by my insurance thank god because I hear it's very expensive.

Charles,
I just had a private message dealing with Neulasta so I read about it. Some health insurance companies are denying coverage because they say the chemo those patients are getting carries a low risk of febrile neutropenia. Some are doing a watch and wait, they'll only cover it after there's neutropenia caused by chemo. Then it would be covered in the future. One patient was denied coverage because of the serious side effects that Neulasta can cause. That one bothers me a lot because most medications can cause serious side effects.
I can't remember the price tag, but it's something like $6,000. for a 6mg Neulasta injection. A 300 mcg Neupogen injection is about $300. When I worked in home health care injectable and intravenous meds were covered by insurance in almost every case.
If a person has no insurance or is "underinsured" (when it comes to medication coverage or really high deductibles or co-pays), Amgen will help and may cover all of the cost. I've said in the past that Genentech said if a person made less than $100,000./yr and their health insurance denied Avastin, they would cover the cost. My brother-in-law made $102,000. in the year before Avastin was prescribed (they check your most recent tax return). They covered 100% of the cost.
Carol

Has anyone had trouble getting neulasta paid for?

C

@charles Thankfully, this is the ONE drug our insurance didn't try fighting. We had issues with Creon, Fentanyl, even his anti-nausea; however, Blue Cross did cover Neulasta without a problem. He has had both the in office injection, and the self-administrating patchbox worn on the arm. It does show on our bill as $6,522 - we only paid the copay.
Also, our doctor was adamant at his receiving either Neulasta or Neupogen when his counts became dangerously low. He is going to try the Neupogen this time & will have to go Friday, Sat, Mon & Tues. I cant comment yet on whether our insurance will fight the Neupogen, let's hope not!
Has your oncologist submitted a form to the insurance company explaining the importance of your receiving this injection? What were your WBC and ANC(neutrophil) counts?

kirasea,
You or your husband can do the Neupogen injections at home. It's kept in the refrigerator and has a tiny needle. Your insurance should pay for the Neupogen. It's cheaper than Neulasta and doesn't have an office visit charge.
Carol

Thank-you, I'll definitely ask him if that's what he'd prefer - especially for the convenience. (and office visit charge) Neither of us have ever had to self-administer any kind of injection, not even to our dogs...we'd definitely need a lesson

I received Neulasta and had severe pain and fever. My doctor switched to Granix --similar to Neupogen-- to inject subcutaneously for 7 days starting the day after chemotherapy infusion ended. I administered the shots myself. Blood tests were drawn in the middle to make sure the white cells count was not getting too high.
I had pain only one time, but I never had a problem after.

Blue Cross Blue Shield refused to pay for Neupogen, but accepted to pay for Granix. the case manager/nurse of the cancer treatment made the necessary calls.

I wonder whether BCBS assigned a case manager to your case. Despite the bad reputation concerning insurances, I must say that BCBS has been quite helpful in my case. A few weeks after my diagnosis, BCBS assigned a nurse/social worker to my case. She would call me every 3 weeks to inquire about my treatment and would ask whether I needed help. She revealed to be very supportive and helpful.

@breg @carolcowan - Thank you both, he tried the Neupogen last time around & only needed 3 injections. He said it "was ALMOST as bad as Neulasta, but a little better". He still had the major fatigue for about a day and a half, but the other side effects weren't as bad.
We have never heard of Granix, and will ask the doctor about that option as well. Maybe he would tolerate that better.
Since insurance has been mentioned, we have BCBS as well - they covered both the Neulasta and Neupogen without hassle.

kirasea,
I think fatigue is coming from many places and Neulasta may be the least causative factor. It probably does cause it somewhat because it's pudshing the produvction of white blood cells and anything the body makes uses energy. I've never had a reason to require taking Neulasta or anything like it, but it seems like the pain is the side effect that's most bothersome. The reason for needing Neulasta is chemo and that causes fatigue in everyone.
For a lot of my career in nursing and in my own case BCBS seemed to be the health insurance company with the least denials. It's good to hear they're still helping. When the ACA is dismantled and health insurance can be bought from any states, BCBS may benefit from that and expand. Hopefully, somehow that will make good quality care easier to access for some.
Carol