Re: Re: .xolair increase refused by doctor - Jo Ann

[Guest guest]

Jo Ann,

I started on 150/month and my doc increased to 150/75 alternating every two

weeks. We were thinking about increasing to 150/150 because the 75 doesn't work

as well as the 150 so I was interested in the formula you wrote: .016 x Kg x

IgE / 2. I weigh 168 or 76.4Kg and my IgE is 44, so I'm taking 76.4 x .016 x 44

/ 2 = 26.89. Something doesn't seem right. What am I doing wrong?

joannnana <joannnana@...> wrote:

>

> My allergist said no to my request for a xolair increase because: (1)

> Medicare would probably not pay for something that is not officially

> recommended by Xolair and (2) There are some unknowns about xolair

> since it hasn't been used very long. He prescribed another inhaled

> steroid (QVAR) to be added to my regular Pulmicort dose when I have

> asthma flares. Hopefully, this will help. Anything will be better

than

> the prednisone.

>

Hi my name Jo Ann I work for an allergist. We currently have 67

patients on Xolair. We have been administrating this drug since 2003.

As far as I know we do have a patient that her dose based on the dose

guide is 150 mg once a month. We called her pharmacy to find out if we

could increase the dose of her Xolair due to increase asthma sx post 3

weeks of Xolair. We did get the approval and now she comes in every 2

weeks. I know MC will pay for the increase as long as your doctor

explains why he would like to increase your dose. If your dose is off

the dose guide and he just started you at 375mg then have him calculate

your dose based on the formula(.016X kg X IgE divided by 2 this will

equal your dose every two weeks. We currently have 3 patients on 600mg

every 2 weeks responding very well.MC will pay for the drug as long as

your provider buys the drug then bill MC.Good luck it worth a try.

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[Guest guest]

jo ann,

did the dr you work with increase the dose on his/her own, or was

novartis/genentech included? my dr knows i need a higher dose of xolair

(currently on 375mg every 2 weeks) but won't go above the 375 because that's all

that is approved by FDA. i've tried to talk her into doing 450, but she won't

budge. (which i understand, if something did happen, her license could be on

the line).

just wondering. if there's an " FDA approved " way to do it, i'd like to bring

it to her attention.

thanks

heather

>

> joannnana wrote:

>

> >

>

Hi

I know this looks and sound crazy.We use this formula if the patient

dose is off the dose guide.If your kg and Ige are with in the dose

guide then that is what your doctor should go by.We use this formula

for those patients Ige is off the dose guide to get a caculated dose.

Of course there are times that a patient should receive 1,200

( example) every two week, no study shown that a patient can receive

that amount. So at that point we start the patient at 450mg every 2

weeks, yes it is lower than their caculated dose, but yet these

patient tend to respond very well. When i go to work tomorrow I will

send you an example of a patient that we have off the dose guide.

Keep in mind that our provider will dictate a good letter explaing

why the dose along with a very detailed history.

Hope this answer your question.

Jo Ann