[DocJohn]

Hi folks,

Does anyone here know the cost (per infusion) of getting a ketamine infusion for RSD/CRPS in an outpatient setting?

Thanks for any help you can provide in helping me track down this information!

Best,
DocJohn

[EnglishDave]

Hi Doc John,

From a search I found this current pricing from Portland:

http://www.portlandketamineclinic.co...RPS___RSD.html

and an article speaking in more general terms from 2013 here from American RSD Hope:

http://www.rsdhope.org/ketamine-and-crps.html

It seems that costs vary widely from Clinic to Clinic, Doctor to Doctor and tying down actual cost for full treatment before embarking on the path is difficult.

Sorry I could not help more. This makes me so grateful for our NHS.

Dave.

[DocJohn]

Thanks for that. I also digged a little deeper and saw a previous member posted about an outpatient treatment of ketamine for $400. So the numbers really seem to be varied.

Which is extremely odd given that (a) infusions aren't medically complicated procedures and (b) a dose of ketamine is like $10.

[EnglishDave]

Tell me about odd! I found courses of in-patient treatments quoted at $25,000 to $50,000 when an iv and the Ketamine costs $50. I know they have staffing costs to treat in-patients, but still.

Dave.

[Littlepaw]

Hello,

I might be the one who posted $400. That is in Austin, TX. It actually ended up being $300 per outpatient infusion for me. This is my co-pay. It must be my insurance company's negotiated rate because I have not hit my deductible yet, so at the moment I am paying all of it. They did approve the codes though. I posted those at one point and can dig them up if they would be helpful...

I am on a low dose protocol so I am not there more than 2 hours. However, I could stay longer if I needed to and don't think that is factoring into the cost.

[mama mac]

Doc John,
Ketamine only, is $600.00 per infusion in Dallas, TX. If other drugs are given it is more. This was a 3 day protocol. It was infused over a 4 hour period. Very expensive for a very cheap drug, even though I know it requires a lot of monitoring. Sad thing is the price keeps many CRPS patients from getting treatment with a drug that is helpful for at least half the patients that receive it. It not like we have a lot meds that effectively treat this condition.
mama mac

[MissyJ]

Hi DocJohn,

I have talked to two different places on the phone to find out about cost. One was $700-$900 per infusion, and they require you to do 10 four hour daily infusions, then 2 per week for a while, then boosters after that. I calculated about $16,000. The other clinic said it was $2500 for each four hour infusion day. I got kind of a yucky money-making vibe from both of them. Neither of them take insurance, but my insurance won't cover ketamine infusions anyway. I'll keep looking into other places.

Missy

[cdwall]

I have a lot of co-morbidities. POTS is a big problem with me in any procedure. I also have Addison's. Yes, even a four hour outpatient ketamine infusion is expensive for me, but I require a lot of monitoring. Plus they give me 500 mg over the four hours, which is a pretty big dose.

So in their defense, it's not the cost of the drug that's the big expense. It's the care. I'm happy they'll even do it at all with my other problems.

The inpatient protocol is usually five to seven days in the ICU. That's just going to cost a lot in monitoring and care.

[DocJohn]

Thanks for all of your replies! This is very helpful...

Has anyone asked their insurance company that doesn't cover ketamine infusions for this condition WHY they don't? It seems like a beneficial, proven treatment...

John

[mrsD]

Here is a Caremark PDF explaining their coverage (or not) of
Ketamine:

http://www.caremark.com/portal/asset...le_Ketalar.pdf

This document states, "prior approval" and this may mean rejection of the claim.

Because of the side effect profile, I would guess that insurances are not eager to cover this treatment. Should the patient become worse with the side effects they would incur more insurance payments to recover. Hence the drug is not typically easily covered because of this.

One should really get insurance information before treatment, as this drug may be covered by some companies and not so by others.