Ibrance® Medicare Coverage

Ibrance®
Chemical name: Etanercept

Typical dosage: 125mg

Typical type: Capsule1

Ibrance® is a medication typically used to treat breast cancer. It is only available as a brand name medication and comes in the form of an oral capsule.

Ibrance is a prescription medication that contains the active ingredient Palbociclib. It is used to treat breast cancer as an initial, endocrine-based therapy as well as disease progression following endocrine therapy in HER-2 negative patients.

It is typically taken once daily for 21 days of a 28-day cycle. Ibrance targets proteins in cancer cells to stop the cancer cells from growing.

The major side effects of Ibrance include nausea and vomiting, hair loss and hair thinning, loss of appetite, diarrhea, mouth irritation or mouth sores, feeling tired or weak, dry skin and taste changes.

Does Medicare cover Ibrance?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Ibrance.1

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.2

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Ibrance.

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Average costs for Ibrance with Medicare drug coverage1

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.		 After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.
$3,409 – $13,635 $3,409 – $13,635

Additional information

Ibrance will likely be given with other medications to help control the side effects.

If you are taking Ibrance, you may have a higher chance of getting an infection. Wash your hands often and stay away from people who are sick.

Tell your doctor if you experience symptoms such as fever, chills, sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores or a wound that will not heal.

This drug can be harmful to an unborn baby if taken while pregnant. Use birth control to prevent pregnancy while taking this drug and for at least 3 weeks after your last dose.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 GoodRx. Ibrance. Retrieved May 2019, from www.goodrx.com/ibrance.

2 Jacobson, Gretchen; et al. A Dozen Facts About Medicare Advantage. (Nov. 13, 2018). Kaiser Family Foundation. Retrieved from www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.