Monday, July 13, 2020 2:40:12 AM
For example my mom first got the drug free since she was included in a trial before the drug was approved.
Then after a number of months the drug was approved but the insurance would not cover any of it because the drug was not on the insurance formulary yet - sure, it was just approved.
That left her with no option other than continue and pay in full, or not continue getting the drug.
For another cancer drug insurance denied it because the drug was indicated for another cancer, and ignoring that the oncologist prescribed it based on genetic analysis of the cancer that was surgically obtained and thus targeted her cancer’s makeup.
Fortunately the hospital has liaisons with the drug companies and helped us submit for financial aid from the drug companies and was able to get the drugs by the good graces of the drug companies for a limited time period. Had her income been a bit more she would have been out of luck.
I wonder how much of these insurance gaps Dcvax will face or whether by nature of being biologic get some better positioning for coverage?
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