It's the same for everything.

I can get a flu shot at a local pharmacy for $8-$10. Sometimes less.

I can go to a local dr and he charges an office visit and $75. So same shot cost $225. If I have insurance, then just the co-pay.

We don't have Universal Health Care. Prices and fees will vary. By a little or a lot.

It is not just this drug, so I don't really see the point on on what I consider picking on it.:confused:

Have you ever priced Botox?

thanks Harry
I have to agree with you. I understand we have diffrent insurances but that would be up to the insurance how much they pay. That should not reflect the amount asked for for the drug at such a big diffrence. The wholesale cost of the drug should be a constant. For someone like Riverwild that has a lifetime cap this seems quite unfair. My billable rate is almost half hers.

I understand Drs visits vary and I did not see as much a diffrence in infusion center rates as I did with the cost of the drug.

Riverwild I am just curious do you go to a Drs office or an infusion center cxconnected to a hospital? I go in both cases to private oncologists. The fl site has not yet posted the amount requested but I am sure the insurance company will pay the same in both. My copay remains $25 where ever I do it.
Good luck to all
laurie f

Do you think it also might depend on how big the size of the center? How many infussions they do? They might get different prices depending on the size of the order.

Curious monkey called our family friend who is also our family dr. :) His cost of flu vaccine is higher than places that set up clinics. He said he does less than a dozen per year.

Just a thought.

7 down
 

I had my seventh Tysabri infusion yesterday. :) There is a delay in my post since I came home at 5 pm and crashed from a low grade fever, exhaustion and a headache. Sometimes I feel like I've been run over by a truck after the infusion! But 24 hours later I am feeling good to go. I also found out I am negative for Ty. antibodies so that is a relief. They did the test at the 3rd month mark but lost it and never bothered to tell me. :mad: I assumed since I did not hear from them I was okay. Anyhow, they ran it again in Dec. after the 6th infusion and of course I sat around and worried because of the fevers-- but again, it was negative.

PS: Biogen just sent me a new drug insert. They've added something new that wasn't there before. It says that slightly low hemoglobin may be a result of the drug. I wonder if this is why I've been showing slight anemia on occasional bloodwork tests?

I really don't think we are "picking" on Tysabri. We are simply discussing why there are such huge differences in cost for MS patients obtaining an infusion. Comparing the cost of a flu shot at a pharmacy vs at a doc's office is a far cry from why some patients are charged $ 3000 for an infusion and some $ 7000!

Harry

River,

I agree that types of insurance do make a difference - however, the #s I listed were the raw numbers that I was billed....what someone would be billed even without insurance...then my insurance adjusted it to their approved/contracted rate, and I paid my share (which was 20%).

What I was saying that Victor could have come to my center (90 mins away) and paid a fraction of what he was paying. That is what I don't get - especially since I live in the "city" whereas where he is, is, uh, uh...well, it is not LA.

I still remain curious :confused: as to why V paid SO much and he had insurance (albeit, it doesn't sound like good insurance!).

~Keri

There are probably several different factors (some of which have been mentioned already) that could contribute to the variance in charges, but my concerns would be:

- the lifetime cap for treatment coverage (mine is one million, which wouldn’t take long to reach at 100K+ per year).
- the cost to the “plan”, which HAS to affect premiums for EVERYONE.
- that we (PwMS) could be pricing ourselves out of coverage (for future patients).

Once these insurance companies “catch on” the PwMS are a HUGE financial burden, I suspect they will eventually start writing in caveats to their plans that exclude PwMS, or at a minimum double/triple premiums for patients that are dx with it. I know that sounds extreme, but they do it for other categories already, so why not us?

A 400% difference is obviously not as major for an inexpensive treatment, as it is when we are dealing in the 10’s of thousands per year.

I think I understand that patients are limited in that they may have to go to a center within their plan, but I can’t see why the insurance carrier wouldn’t “agree” to an “exception” if it is going to save them up to $60K a year? :confused:

Cherie

I use an oncology infusion center connected to a hospital.

The debate about the cost also has to take into account that some people's Tysabri is covered under their prescription plan. Some people have it covered under major medical with the infusion center supplying the drug. Some physicians supply the drug.

The cost of the drug when it is associated with a middleman is a doubling in cost. There are only so many pharmacies that you or the infusion center can order Tysabri from. So when the insurance prescription plan orders from the supplier, they pass some cost on to your plan. When the infusion center orders through THEIR supplier who orders through the central pharmacy that is TWO adds to the cost. They pass that cost on to you or your insurance plan. If the doctor orders the drug through his supplier who orders it through their supplier who orders it through the central pharmacy, and supplies it to the infusion center...

argh...

Some Tysabri news
 

Biogen says they will begin posting weekly to their site on any new cases of PML. Thomas Gryta of DJ reported it today. I do not have a link but I am sure it is out there since Biogen had a conference today. When I have a link I will edit this and post the link, or someone else can add it in here.
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http://archneur.ama-assn.org/cgi/con...act/65/12/1655

Juvenile MS treatment study abstract. This appears to require a subscription. I am SURE that someone out there with lots of time can find the full abstract if it is out there and available.:cool:

I have the full abstract/study but since it is a paid subscription I cannot cut and paste it here.

In a nutshell, three case studies of juveniles with aggressive MS who are under treatment with natalizumab and their doses and the success of the treatment, along with length of treatment and previous treatment. Good stuff. All three doing well. QOL up, no relapses, symptom improvement seen, stabilization in all three cases as in no clinical disease progression seen. Dose modified for size. Duration of treatment- 24 months, 16 months, 15 months.

Wow! Thanks for the explanation.

Where given a choice, I would still ask why not CHOOSE the cheapest option? :confused:

Cherie