treatment cost and coverage Update

So today I received a call from Roche or a representative for the compassion program. They are going to try and get me Rituxan. To start with they contact your private insurance.

So my private insurance covers up to 2,000.00 a year for pharmaceuticals! The policy is you pay first than they reimburse you. It was during the 3 way conversation with my private insurance and the compassion program person that I interrupted and clarified that the cap was 2,000 for all medications.


According to Roche the cost per dose for Rituxan is approx. 3,300.00 and I need 4 doses. So total it is $13,200.00 even if you minus private insurance 11,200.00 is still too much to pay.

I explained to the woman that I did not even have 2 thousand laying around to pay up front so I would need to try and get a loan. So now the nice lady from Roche is now calling her boss to see what needs to be done next and what other options are there.

Spent almost 2 hours in total on the phone today. Only to find out what I knew already.


What I learned today is that I'm very grateful that most of the treatments I need are covered by my provincial health coverage. I am grateful that I have a treatment that works and even more grateful I do not have to pay out of pocket.

Julia - the data on low dose Rituxan success or fewer treatments has been pretty good, so looking into that might save you quite a lot of money.

Hmmm, isn't it funny how things are different in each Province. Julia, you live in a bigger one than me, yet, I got my Rituxan at no cost to me. I wonder if it would be the same if I needed to do it again.

Hope you get good news soon and can get it at no cost to you!

Cindy the kicker is there is a form that if my doctor fills out OHIP will pay for it. Because i was part of a drug study.

Not sure why there are differences between provinces. Do you still have your spleen? Do you respond to treatment?


Sandi I am happy to stay with Rhogam if I can't get Rituxan. Sooner or later I'll get frustrated and download the forms and make him fill them out!

No, I had my spleen out in 2006. Did Rituxan in 2010 and have been in remission since.

Just received another call from Rosche since my insurance will only cover 2,000 and they received the paperwork from my doctor. Supposedly he crossed his t's and dotted his I's.


The man I spoke with say he was certain I would get it! So within the next 2 weeks I'll know!