Approximately 3 million men in the United States have been diagnosed with prostate cancer. Treatment methods have seen advancements, but surgery and hormone therapy are still considered some of the most effective options when this disease is detected early. Unfortunately, no treatment method is flawless, and in some cases, surgery in conjunction with hormone therapy is unable to stop the spread of prostate cancer. While prostate cancer can metastasize like many other cancers, it often targets bone material when it spreads to other systems. In such cases, treatment options like Xofigo may be necessary to extend life.
What is Xofigo?
Xofigo is the brand name for radium-223, an isotope that is used to fight the spread of cancer from the prostate into the skeletal system. This treatment is generally administered when surgery and hormone therapy have been tried but have been unsuccessful. As such, Xofigo is often viewed as a drug that is meant to extend life expectancy as opposed to eradicating cancer from the body.
Patients receiving Xofigo treatments need to be aware of signs of dehydration as these can lead to serious complications. In addition, people undergoing treatment with Xofigo should be careful regarding bodily fluids after receiving an injection due to the radioactive nature of the radium-223 isotope. Side effects may also include low blood cell counts, so follow-up and routine blood testing may be required as part of a treatment plan.
Medicare Coverage of Xofigo
Medicare does typically cover Xofigo under Part A when the injection is administered in a skilled nursing facility as part of a short-term stay. Treatment plans generally consist of one injection every four weeks for 24 weeks and a total of six injections. Medicare Part B also provides coverage for Xofigo in most cases when the drug is administered in a physician’s office or at an outpatient certified clinic.
The Medicare Part D prescription drug benefit does not apply to Xofigo because the drug is an injectable treatment that cannot be taken at home or dispensed at a pharmacy. In many cases, Xofigo’s eligibility for Medicare coverage may be contingent upon other treatments being ineffective first, including hormone therapy and surgery. Your physician may be able to get an exemption if the use of Xofigo is medically necessary and the best choice for more effective treatment.
Because Xofigo is meant to extend life instead of curing disease for men facing advanced prostate cancer that has spread to bone, you may also be eligible for additional Medicare coverage benefits like hospice care. Hospice services are provided under Medicare and allows for care and comfort in one’s own home. If this is the route you feel is best, you will need to discuss and review your options with your physician.
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