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Gab122
09-03-2016, 07:39 AM
Hi all,

I Rec'd an approval from my insurance company for
rituximab injections 100 mg (100!?!)

number
6

Service dates
8/8/16-2/8/16

Type of service
Month

Then it says
Rituxan 1000 mg every 4 months

Here's the question:
Does Rituximab 100 mg =
Rituxan 1000 MG?

What does number 6 indicate?
6 infusions? Service type monthly?

But it says every 4 mos (b/n 8/8/16-2/8/16)

I'll call my insurance but wanted to run it by you all to see if this approval makes sense?

Thx
Gab

drz
09-03-2016, 10:44 AM
Rituxan Pronunciation
Generic Name: rituximab (ri TUX i mab)
Brand Names: Rituxan


RITUXANŽ (rituximab) is indicated for the treatment of:


Low-grade or follicular CD20-positive non-Hodgkin's lymphoma as a single-agent therapy in patients whose disease recurred or did not respond to initial treatment Follicular CD20-positive non-Hodgkin's lymphoma as an initial treatment with chemotherapy, and in patients whose initial treatment was successful, as a single-agent follow-up therapy Low-grade CD20-positive non-Hodgkin's lymphoma as a single-agent follow-up therapy for patients who did not progress on initial treatment with CVP chemotherapy CD20-positive diffuse large B-cell non-Hodgkin's lymphoma as an initial treatment in combination with CHOP chemotherapy CD20-positive chronic lymphocytic leukemia in combination with FC chemotherapy as an initial treatment or as a treatment after disease has recurred Rheumatoid arthritis with another prescription medicine called methotrexate, to reduce the signs and symptoms of moderate to severe active RA in adults, after treatment with at least one other medicine called tumor necrosis factor (TNF) antagonist has been used and did not work well enough Granulomatosis with Polyangiitis (GPA) (Wegener's Granulomatosis) and Microscopic Polyangiitis (MPA) with glucocorticoids
People with serious infections should not receive RITUXAN. It is not known if RITUXAN is safe or effective in children.

Gab122
09-03-2016, 10:19 PM
Hi Drz, thx for info. Actually I was wondering about the difference listed regarding dosage. One says 100 mg. The other 1000 mg.

Alysia
09-04-2016, 03:42 AM
100mg is a mistake they make here as well. No idea why.
I get 2000mg, in 2 infusions, each one 1000mg. 2 weeks between. Every 6 months.
Each 1000mg here comes in 2 ampules, of 500mg each. There is no ampule of 100mg so dont worry.

DWendy
09-04-2016, 04:09 AM
Is it possible that the vial says micrograms and not milligrams? The symbols are quite similar.......mg for milligrams but something that looks like a scripted u g for micrograms. Ask any Nurse who works nights (lights dimmed and tired eyes) how easy it is to mix them up!!!


Sent from my iPad using Tapatalk

Gab122
09-05-2016, 02:31 PM
Wendy- Actually I was reading it on the letter I Rec'd from my health insurance. No symbols. I tried calling but they were closed already. I'll call Tues.

MaxD
09-06-2016, 06:41 AM
Gab: I generally ignore these forms coming from the insurance company. The docs send in the request and get the approval - if anything is amiss the docs office will take care of it. Rather than calling the insurance company (sure way to get frustrated), you could check with your docs office for peace of mind.

By the way, the docs office (or the hospital) should also be applying on your behalf for the Genentech co-pay program. Any co-pays for RTX are covered by them (but not for incidentals such as the procedure, the solumedrol and benadryl).

Gab122
09-06-2016, 10:56 AM
Hi Max, MGH did apply for the Genentech copay program! I believe my out-of-pocket is something like a total of $14
Something crazy great like that! :)
I've maxed-out my spending pretty much this year so we hardly have to pay for anything anymore (til Jan)
:thumbup:
Good Idea to check w/ dr. office - they are on top of all that stuff!

Jaha
09-07-2016, 02:25 AM
I think it could be a billing code that measures the RTX per 100mg as a unit and 10 units would be 1000mg of RTX. I believe that is how they have to bill it to get paid correctly. When I get my approval papers it always says for 100mg along with the CPT code descriptions on it.

Gab122
09-08-2016, 01:12 PM
Jaha- you were right. I was approved for 100 mg X 10 units per infusion and X 6 infusions (b/n now and feb 2017.) Then i guess they battle it out for the next 6 months of meds. [emoji4]