My endocrinologist prescribed the Somavert and I believe she had to get approval from Blue Cross. My memory is very bad, but I believe she may have been responsible for Pfizer Bridge program representative contacting me and they had me get in touch with Patient Access Network who assists patients with different diagnoses with their copays and also sometimes premiums. I was preapproved, but by the time I got my paperwork in they had disbursed all their funds for acromegaly and suggested I reapply later. There are other organizations out there that will also help with copays and premiums, and you can apply and get assistance from more than one if necessary. Pfizer Bridge actually had a program that Tennessee had never before participated in, so my Pfizer Bridge contact made a few phone calls, she said, and Pfizer ended up helping me with my copays which at this point are $100/mo. That will likely change after next week when I see the endocrinologist as my IGF-1 was 711 when checked about a month ago. They will help with up to $300/mo in copays for Somavert. They sent a card which I use when the bill from the specialty pharmacy comes. I am so grateful for the help I've received, and not because I even knew to ask. There are some really wonderful organizations and people out there. I hope you find the help you are looking for, too.

In a nutshell: If your endocrinologist has prescribed it, Google prescription assistance programs, make application to the ones that will assist with acromegaly, and have your endo contact the Pfizer Bridge program on your behalf. You may be able to get in touch with them directly, but they will also need to get confirmation from the endo.

Thanks so much. Granin. Yes, Pfizer Bridge got in touch with me as well. And, though $100 is a big discount it still seems like a lot. But, worth it, of course!

Blue Cross denied all appeals to cover it with my prescription program. But, I'm curious if other insurance companies would.

Did you have surgery? I noticed in some of my research that certain insurance companies only covered drug therapies AFTER surgery. I wondered if that might be what you are encountering or if it is something different. I don't know if I will be prescribed meds yet, but my insurance is BC also and once I find out more I will be happy to share.

Thanks!

Yes, I did have surgery. But, maybe Pfizer did not include that in their appeal to BC. I'll have to research!

I was denied coverage for a screening colonoscopy despite all my doctors could do because my company didn't purchase a rider for health screenings when they negotiated our insurance plan. Even the insurance company was stunned about that! I wonder if your employer perhaps didn't include something in your insurance plan with Blue Cross? Don't tell anyone, but my PCP "manipulated" the rules to make it possible for me to get a colonoscopy.

This is a notable thought for everyone because as we know insurance companies take pride in denying claims despite knowing that octreotide doesn't control acromeglay entirley leaving patients deformed.

Acromeglay is an orphan disease, according to the orphan disease act don't you think our disease should qualify for coverage necessary to treat our disease?

Has anyone ventured into this arena because BCBS is the dominant insurer that most tend to follow after all.
If everyone banned together then we should be entitled to recieve our medication through the orphan disease drug act and this would eliminate the need for battling one's insurer.

After reading this thread I am glad that I live in the UK. No such problems here.

My company deals with Manulife Financial and my Somavert is covered 100%. I don't even have to pay the dispensing fee!

Endo wrote the prescription, and it was approved. No questions asked.

My insurance company in Canada covers 80% of my peg rx.

Colin: No offense, but I was told that in the UK they won't approve pegvisomant until you have had gamma knife radiation. I know that sandostatin is covered. Do you know if this is accurate?

Thanks,

Mish