Quote:
Originally Posted by katty
Hi,
I called the insurance company and requested an audit. They were not interested. I called the hospital and was told that I was lucky there was anywhere to go for this. I was also told they charge $20 for an aspirin.
I live in Santa Cruz, California. The costs are high here, but I know from the Elan website that the drug cost is less than $2500. The hospital charges $12,000 for that. They tell me this is because they have to cover the costs of other stuff they do at the hospital. I think that stinks.
I know someone who had a baby recently. It was a normal delivery. The hospital charged them $30,000. For now I'm going to calm down and be happy the insurance is willing to pay this outrageous bill.
Maybe I can convince the Neurologist to start doing the infusions at his office.
Katty
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Katty
It's not a matter of whether or not you can
convince the neuro to infuse you at his office, he has to be TOUCH certified to infuse AT his office. There is a very detailed TOUCH protocol training and certification process that his office must go through in order to become an infusion center. And he has to have a TOUCH certified and trained RN on duty, not just someone in the office. That's why a lot of neuro's don't have infusion centers in their offices.
Biogen (not Elan) is trying to get a handle on these cost over runs because it is hurting the overall big picture for patients who really need this drug not getting it because some insurance companies (like mine) are refusing to put it on their formulary.
Don't misunderstand me, I am no long eligible for Tysabri because I am in a clinical trial for Tovaxin. I got tired of fighting my insurance company. I did testify to bring Ty back on the market and was on an FDA RiskMAP panel representing the MS Community discussing the PROs and CONs of the TOUCH protocol for Tysabri.
There are other areas of the country that are a lot more expensive than Santa Cruz and have only one or two patients being infused. As an example: here in Idaho, one place I know has only one patient that has a travelling infusion center and they pay no where near what you are paying. If your insurance company isn't interested in performing an audit...that would make me wonder why! Oh well.
As you said, you are lucky your insurance company is willing to pay these outrageous costs! I am also happy that Tysabri is working for you.
Keep us posted on your progress! I hope you continue to improve!
