Levorphanol

[myrandom2003]

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Has anyone been able to get levorphanol covered by insurance? Are there reps or copay cards for this?

I know it’s generic but there’s got to be something. I have a few cancer patients that I think this would be great for but can’t get it approved.

In one patient I admitted to hospital and put on a ketamine drip for 3 day infusion. Worked wonders but it was a last resort type of situation.

Need easier accessible NMda antagonists other than cough syrup.

 

[Orin]

We used to go through a specialty pharmacy for that drug/PAs but I haven't prescribed that in a while.
Dunn Meadow - Dunn Meadow

A quick perusal shows that it is on some private insurance coverage lists but has a lot of documentation needed. (https://www.azblue.com/~/media/azbl...ecertification-forms/levorphanol-tartrate.pdf)

You could consider compounding ketamine for oral/sublingual/nasal delivery with the understanding that bioavailability is not the best. There's supposedly a transdermal formulation on the horizon but I'm not sure how long that'll be.

I've tried memantine and amantadine but primarily for fibro, not cancer

 

[lobelsteve]

Have a few patients on it. Reps set my office up with a pharmacy that does the prior auth. Not any more expensive than other long acting and most insurances covering it.

 

[myrandom2003]

Can you share your reps info?

I’ll reach out to the local compounding pharmacy. There is an intranasal ketamine spray indicated fir depression recently out. Looking into get that covered.

 

[BobBarker]

I have two patients that both get it at walgreens. One is on Tricare and the other bobs.

 

[No_Pain_No_Gain]

Have a few patients on it. Reps set my office up with a pharmacy that does the prior auth. Not any more expensive than other long acting and most insurances covering it.

Unfortunately, it is actually much more expensive than most other long acting/brand name opioid medications. The listed retail price on GoodRx ranges from $3000-$4000 for the standard 2mg dose, 90 pills. I confirmed this with the rep in our area. IMO, this exorbitant price point is quite a shame as the NMDA antagonism can be quite efficacious in the right patient population.

 

[lobelsteve]

Can you share your reps info?

I’ll reach out to the local compounding pharmacy. There is an intranasal ketamine spray indicated fir depression recently out. Looking into get that covered.

Kelly.


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