currently being treated with xiaflex $50 copay

[Bummed about PD]

I am new to this forum. I was approved for Xiaflex (up to 4 sessions of 2 injections each) After being pre-qualified as a candidate, I was informed on my birthday of my $50 copay! 7000 per phase 50 bucks my share with a 105 dollar office visit. Important when pre qualing-- Answer no pain to the Xiaflex rep to establish that the plaque is not currently forming and yes to pain when talking to the specialty pharmacy so they approve you(in other words, no pain flacid, pain erect) Super important! I am currently doing the modeling after the first stage but have already noticed a reduction from the pre-existing 80-90 degrees down to about 40 degrees curvature and about a half inch in restored length. Will keep this thread updated as modeling continues. They are telling me to stretch and model for another 5 weeks before moving on to phase 2 if necessary. Go to Xiaflex's site and enter zip to find local Dr. I am in Florida and my Dr. Is Thomas Suits in Stuart.

[james1947]

Bummed

I moved your post here that other members can read and learn about your Xiaflex experience.
Please continue to update us.
Wish you "strait again" and get back your original size.

James

[Mending the Bend]

Today I finally got around to calling the Auxilium Advantage program (from the Xiaflex web site) which supposedly reimburses your co-pay for Xiaflex, up to $1000 per shot. To my great surprise, they asked for my name and were able to confirm within 5 minutes that I am approved for the program. All I have to do is send a copy of my EOBs which indicate the patient-responsible amount (in my case about $1130 for each round). Since they reimburse up to $1k per shot, and mine is over $1130 for two shots, I am getting it all back - for a total reimbursement of over $4500 from Auxilium.

My only out of pocket will now be the doctor and facility co-pay amounts, a pittance in comparison. This makes me almost as happy as my curve reduction so far. Almost  

In order to qualify so easily, I think you have to submit your original Auxilium Advantage application along with your doctor when you are applying for treatment. Mine did. Check with your doc.

Mending the Bend (less expensively)

[james1947]

Good information Mending, hope others will read your post, proceed per your advice and get back they money too.
From Mending:
In order to qualify so easily, I think you have to submit your original Auxilium Advantage application along with your doctor when you are applying for treatment.

James

[hope4all]

This information is (In)valuable!  Thanks so much Mending and Bummed. I'm scheduled for an initial visit on Oct. 24th with a doctor on the Xiaflex list. His name is Dr. Kava..PM me if you have any knowledge of this doctor in Miami or Plantation, FL.  

Bummed - Stuart, FL isn't that far from Miami. I would consider driving an hour or so for a good doctor especially after having 6 verapamil shots from a doctor who didn't have the best aim.  How long did it take from the time you saw the doctor to get approved and get your first shot? Did you have an ultrasound done?  Would be interested to hear more.  Also, is your doctor part of a hospital system or a completely private office?

Dr. Kava is part of U of Miami so the billing is totally different for me than it would be for a private doctor's office. $35 specialist copay vs. $350 plus 10% if I go the outpatient hospital route. I will still apply for the advantage program just to be safe.  Thanks again guys!

[Bummed about PD]

Bummed - Stuart, FL isn't that far from Miami. I would consider driving an hour or so for a good doctor especially after having 6 verapamil shots from a doctor who didn't have the best aim.  How long did it take from the time you saw the doctor to get approved and get your first shot? Did you have an ultrasound done?  Would be interested to hear more.  Also, is your doctor part of a hospital system or a completely private office?

Hope4all-

I had my initial consultation 8/27, gave pictures to justify qualification for Xiaflex with rep, Tony on 9\9 and  it was submitted to BlueCross who then said it had to go through their specialty pharmacy . Office manager tried pre-qualing initially on 9/15 with specialty pharmacy, retried on 9/17 answering YES to pain (remember the flaccid/erect part of my 1st post), they called me asked for the $50 co-pay and drug was in office on 9/19 for my first cycle on 9/23 and 9/26. The rep, Tony said he had one (lucky) patient that went from 80 degrees to 8-10 degrees after 1 cycle of 2 injections. Depending on your tolerance for pain, you might want to consider having a driver if the Dr. has to prescribe demeral to keep you from jumping off the table. I would say if you already have pics from either side and front on and one with a ruler under( so they can use a protractor to determine angle during candidate pre-qual) , you could probably be pre-qualified in about a month from initial consultation. If you explain to Michelle or Maureen in the office that you are coming long distance, they could probably arrange to have Tony there on initial consultation if you have the pics with you and they could have you prepared in advance. My best wishes for you.

Urology Specialists of Stuart: Suits Thomas C MD
401 SE Georgia Ave Stuart, FL 34994
(772) 220-9871

[hope4all]

Thank you Bummed, all great inside info that I will use! Hope all is progressing well with you.
hope4all