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Medicare Part D Out-of-pocket Costs for XTANDI

If you would like help determining a Medicare patient's potential cost-sharing obligations, use the Medicare Part D cost estimator below.

This cost estimator is intended to provide an understanding of the Medicare Part D benefit structure, including coverage levels, Medicare and manufacturer subsidies, and out-of-pocket requirements for patients.

Understanding Medicare Part D Cost-Sharing
2014 Standard Medicare Part D Structure*   Patient Out-of-
Pocket Cost*
Total Drug Cost Patient Responsibility
(TrOOP), cumulative
  Plan Cost
    Drug Company
Cost
     
 

 

 

 

   
 

 

 

 

   

Click boxes above to see patient out-of-pocket costs at each Medicare Part D coverage level.

  • A deductible is fixed-dollar amount that must be satisfied before the insurer will pay for any drugs or services.
  • The standard Part D deductible for 2014 is $310.
  • However, only 43% of plans will charge the full deductible amount. 47% of plans will have no deductible.
  • This tool is not intended to guarantee specific patient cost-sharing amounts for XTANDI.
  • The estimates above reflect a standard Part D benefit; a patient's actual Part D benefit structure may vary. However, as all Part D plans are required to be actuarially equivalent, total annual out-of-pocket costs will be similar to the standard plan shown above.
  • Patient out-of-pocket costs under Medicare Part D will vary according to the prescriptions filled under the Part D benefit, and costs will accumulate as prescriptions are filled.
  • Specialty medications, like oral oncology agents, may cause the patient to incur higher out-of-pocket costs earlier in the year when compared to lower cost medications.
  • Patients with higher-cost specialty medications will reach the catastrophic coverage period earlier in the year, resulting in lower coinsurance levels for all medications for the remainder of the year.
  • The above information does not apply to patients who qualify for the Low-Income Subsidy available under the Medicare Part D prescription drug program. Low-income patients will have substantially reduced out-of-pocket costs.

Click here to learn more about how XTANDI Support SolutionsSM can help Medicare Part D patients afford XTANDI.

*Figures provided are only estimates. Individual patient cost-sharing can vary based on plan design. This information is valid for the 2014 benefit year only. Medicare Part D benefit structure changes on an annual basis.



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