Do they re evaluate lung capacity to renew Radicava?

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Romeosc

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Joined
Jan 2, 2018
Messages
131
Reason
PALS
Diagnosis
11/2017
Country
US
State
TN
City
Memphis
I know to be on Radicava required 80%... I am on 5th month of infusion and lung power has gone down...

Will they kick me off?
 
It depends on your insurance. Different policies have different requirements to renew. Try to google combinations of insurance co name radicava prior authorization. It may also be somewhere in the company’s formulary
 
I just checked my insurance ( it is specific to New England so it won’t be yours). They do require 80 percent or greater for continuation. This doesn’t mean yours will have that rule but at least one company is doing it
 
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Romeo, even if they don’t “kick you off” for being < 80%, ask yourself how well this treatment is working for you if you were over 80% at the start and are now less than that. If you drop significantly, say < 70%, why would you want to continue?
 
Karen makes a very good point. I have a friend who went on and her FVC went down within a couple of months. She decided to discontinue.

How are you functioning in other areas besides breathing?
 
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