Da Plan, Da Plan!

With props to Herve, I donned my metaphorical white tux (as opposed to the actual white tux I wore to the prom in 1984) and enthusiastically welcomed the arrival of a plan tonight.

Da Plan is to start on the new drug, Stivarga, in a couple of weeks. It's an oral therapy that works differently than the other forms of chemo I've taken so far, and that's a good thing. You want to keep hitting the cancer from different angles, never giving it a chance to say, "oh we've seen this before." The routine is three weeks on, one week off. Side effects are similar to my original chemo drug, Oxaliplatin; namely, hand/foot syndrome and everyone's favorite spelling bee word, diarrhea.

This is also the most expensive drug I've ever taken. Chemotherapy delivered via IV or port is generally not billed as a drug under your prescription plan. But oral chemotherapy is billed that way, just like your birth control and your viagra (quite an interesting combination, if you ask me.) Whereas the insurance companies created Tier 3 for designer drugs like Viagra, they needed a whole new level of expensive for oral chemo, so they created Tier 4. Stivarga is Tier 4. It retails for $11,000 a month (American money - I asked). Under my plan, I would be responsible for 25% of that. So my out of pocket cost would be a very reasonable $33,000 a year. Fortunately, my plan caps the maximum Tier 4 out of pocket cost at $2500 a year, so when your insurance rates go up by double digits next year, you can send those thank you cards to me.

The drug trial the Wizard mentioned is another good option, but not a convenient one, since there are no trials of that drug or similar agents currently in Atlanta or within a few hours of here. If I lived in NYC, it would be worth doing. If the drug progresses down the path towards release, there will be larger trials in the future in which I could participate, if I even need a new Plan.

For now, Da Plan we have is Da Plan we're going with. I hope this does the trick, without knocking me on my butt for 3 out of every 4 weeks. Because as many a B-list actor learned in his/her guest appearance on Fantasy Island, I'm trying to be careful what I wish for.