Kalydeco and Insurance

[zeeannie]

Is anyone taking Kalydeco that is covered by insurance? Are they paying?

CF Services Pharmacy lists Kalydeco around 30K/month. If I add up how much they charge for my daughter's current CF meds it doesn't add up to anywhere close to 30K. Do insurance companies look at that? Even with a once a year hospital stay I'm pretty sure they'd end up spending less paying for CF meds and hospital stays than they would paying for Kalydeco.

 

[Gorf]

I had a stay in the hospital last year when a rep of the drug company came by to discuss it with the hospital staff that takes care of us adult CF's. I was aloud to set in and learn. If I remember correctly if you make under 150k they will give some kind of discount, most likely depends on the actual amount you make and how much you pay.

 

[JENNYC]

Zeeannie CF Services Pharmacy is between 5-6,000.00 over priced. If you shop around you can find it for 24,996 or something close where CF Services Pharmacy is 30,000. They just recently increased...by no small amount because they use to be 24,996.

Also Abby is 7 and taking it off label, her mutations are DF508 & 2585delT, and our insurance is covering it no questions asked. Sadly I think many insurances aren't covering like ours is. But I also think that not a lot have tried to get it off label or have tried and the dr won't prescribe it. We celebrated 1 year no hospital stay in March!! Normally her insurance company would be paying for 2 hospital stays and lots of antibiotics, chest x-rays and such. She has also had 15 surgeries..mainly to do with sinus' and we haven't had surgery in 2 years now. But I do agree even with all of that it doesn't add up to 300,000 per year.