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Medicare will no longer cover Nplate?

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15 years 2 months ago #6316 by donswife48
Medicare will no longer cover Nplate? was created by donswife48
As I was doing research today on Nplate, I ran across a statement on Wikipedia which said "As of June 2010, Medicare in the USA considers romiplostim and eltrombopag to be experimental under Medicare reimbursement guidelines and does not cover the cost of treatment, effectively making these drugs unavailable to many elderly ITP patients." Guess if it works for Don, I'll just keep on working. I'm guessing this is more about cost cutting in Medicare than experimental though.
  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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15 years 2 months ago #6320 by Sandi
Replied by Sandi on topic Re: Medicare will no longer cover Nplate?
Well, I don't know if it's true or not, but Wikepedia is not a reputable source.

Many insurance plans do not cover experimental drugs. Others might know if it's passed that stage yet; I don't think so though because people using it are still following strict protocol.

Some people are still fighting to have Rituxan covered and it's been around since 1997.
  • youngjoan
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  • I founded PDSA after recovering from ITP (7 failed treatments,zero count.) Read my story on the web site (search on 'success story.)Read more about me and my book, Wish by Spirit, at www.joanyoungwrites.com
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15 years 2 months ago #6824 by youngjoan
Replied by youngjoan on topic Re: Medicare will cover most of Nplate & Promacta
Here's the latest information on Medicare and the TPO agents. Wikipedia has been updated with information from Amgen. The sentence now reads:

"As of June 2010, Medicare in the USA will cover most of the cost of romiplostim or eltrombopag treatment under Part-A." en.wikipedia.org/wiki/Idiopathic_thrombocytopenic_purpura
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15 years 2 months ago #6826 by donswife48
Replied by donswife48 on topic Re: Medicare will cover most of Nplate & Promacta
Thanks Joan, I had noticed the update a couple of days ago. Although I still have Don on my employer plan at work, he also has Medicare because of his disabilitiy. I do think it's strange that they changed coverage from Part-B (injectible meds) to Part-A (which I thought required being hospitalized). Presently he goes to his hemo once a week for a blood draw, then according to his platelet counts, receives a shot and goes home. Certainly not a procedure that would require a hospital setting I would think.
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