Lynparza - a very expensive Drug

I had rarely thought about the cost of prescription drugs. We pay for family health insurance that covers 80% of most prescription drugs. When we turned 65, we became illegible for the province of Ontario's Drug Benefit program - only the computer can figure out who pays what but most drugs end up costing nothing!

Last year I had the experience of going to the hospital for cancer treatments and surgery. Drugs and IV treatments given to you in a hospital and cancer centre are free. So when a maintenance drug Lynparza (olaparib) was recommended for follow-up treatment, I didn't think about the cost.  I asked when I could start - the oncologist said less than 12 weeks after my last chemotherapy (Online information said you start Lynparza 8 weeks out). The doctor said he would start the "process" (several weeks ago another doctor said he was starting the process).

No one in the medical system mentioned Lynparza's cost. I had asked my pharmacy if the drug was covered by my insurance and they said 'yes'. I called the insurance company and they said it was 80% covered. I had no idea how to ask the Ontario government if they covered the difference.

When weeks went by without hearing anything, I phoned the support nurse at the hospital to say I was still waiting to hear from the compensation office at the hospital. She said she would check into it. They called 2 days later to tell me I needed to hear from the drug manufacturer about their financial programs to help pay for the drug. (No one could tell me the cost.) They put in a request and only two hours later someone from Astrazeneca who could barely speak English called - I think they offered to cover the co-pay 20% difference. After they made me listen to a very long privacy agreement, they said they would be email the doctor's office. The prescription and payment confirmation arrived at the pharmacy that day. When I called the pharmacist she confirmed the 20% payment was covered by Astrazeneca - $1740 for a 30-day supply! Yikes, that means the drug costs $8700 for 30 days. Unlike others, this drug didn't come with a receipt showing the cost. There was only one refill listed on the prescription, but followup by the oncology team is required. I've started the drug and both the hospital nurse and someone from Astrazeneca phoned me to confirm the date I had started.

The good news is that I'm feeling great on day 5 and should live 3 years longer without a recurrence of the cancer - statistically of course. There's no "cure" but none of us are getting out alive anyway. :)