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Cost of IVIG

Discussion in 'Antivirals, Antibiotics and Immune Modulators' started by SOC, Jul 22, 2015.

  1. SOC

    SOC

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    A question for anyone else currently receiving IVIG -- are you willing to share roughly what you are paying?

    When I looked up the cost online, it looked like the average cost was about $3000 - $5000 per infusion. I just got my bill and the latest charge for IVIG was about $15,500, well over three times the amount reported in a number of sources -- and I'm not up to full dose yet, so the blood product cost should increase with future infusions. This is not a horrible burden for me personally because at that rate I went over my insurance catastrophic limit with the first infusion, and I have good insurance, so my annual out-of-pocket will be no more than it would have been if they had only charged me $3000 per infusion. The catastrophic limit is the same either way.

    Still, I'm upset that my local medical monopoly seems to be grossly overcharging for everything. Or is it now typical for a normal <10 minute office visit for a uti to cost $350? My insurance company doesn't think so because it will only pay $160, so my $20 doctor visit copay becomes $190 due to what the insurance company considers overcharging (as do I). My ME/CFS specialist visits don't cost that much, well maybe they do, but they spend an hour or more with me, not less than 10 minutes, and my insurance company considers that a reasonable charge for the time allotted. Imagine if my ME/CFS specialist charged me the same per-minute rate as my local medical monopoly! :eek:

    To add insult to injury, when I see the hematologist, they charge me for 30 minutes because I'm talking to some staff member -- a nurse, the scheduling person, or the billing person during that time, even though the doctor only talks to me for 5 minutes, and really about nothing since I'm only there for the infusion. "Hi, how are you feeling? Your last labs looked better, let's keep doing what we're doing. Bye." He's a nice guy and all, but I don't need a $400 visit for that. We could just call that one in, thanks.

    Am I just hopelessly out-of-date regarding current medical costs in the US? Or does this sound crazy to anyone else?
     
  2. Ema

    Ema Senior Member

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    I think they bill around 10K/month for my SCIG which has no hospital costs involved since I self infuse. It's nuts how expensive it is.
     
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  3. Never Give Up

    Never Give Up Collecting improvements, until there's a cure.

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    The rates are inflated to be able to accommodate the insurance company discount, or contracted rate. Your physician fees include his time, insurance, rent, utilities, and support staff. Everyone's got to make a living to stay in business. Almost no one pays full charges, even cash paying patients will get a much lower charge when asking for the cash discount.
     
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  4. SOC

    SOC

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    Okay, so not so bad as I thought. :) It certainly isn't costing me a lot out of pocket... well, a lot more than I expected anyway. It was a bit of a shock to see a $30,000+ bill when I was expecting something closer to $8000. Looks like I shouldn't believe what I read on the internet. :p

    I understand the concept of overhead, but I don't really understand why my local medical monopoly's overhead should be vastly more than that of my ME/CFS specialist and double what my good insurance company considers fair and reasonable for my area. It's pretty painful to pay nearly $200 out of pocket for a simple 10 minute GP office visit when according to my insurance, my total out of pocket for that kind of thing should be $20. Life is full of rude shocks these days. ;)
     
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  5. Sidereal

    Sidereal Senior Member

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    $350 to see a GP? Man, that is obscene. I thought Ireland was bad (60-70 euro for a 10-minute PFO experience).
     
    SOC likes this.
  6. maryb

    maryb iherb code TAK122

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    @Sidereal - (having just got up) I read UFO in your post, confused me even more for a few seconds....:)
    although I don't know what a PFO is?
     
  7. sarah darwins

    sarah darwins I told you I was ill

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    Is there any prospect of the cost of IVIG infusions coming down? Even at the lowest rate mentioned above it would be out of reach for a great many patients.
     
  8. Sidereal

    Sidereal Senior Member

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    halcyon likes this.
  9. maryb

    maryb iherb code TAK122

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  10. justy

    justy Senior Member

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    IVIG costs 460 euros a month at my doctors clinic in Europe. The cost of the drug is 400 euros and 60 euros for the infusion - I know this low cost is unusual, but it goes to show how much money they are making out of it elsewhere.

    They used to charge £800 pounds per infusion at Breakspear, but refused me it on the grounds it was too dangerous.

    I pay 80 euros now for a 10ml vial that lasts me one and a half weeks (low dose sub q injections)
     
  11. sarah darwins

    sarah darwins I told you I was ill

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    That's $505 at today's exchange rates. That's a spectacular difference. So who is pocketing all the money in the USA?
     
  12. Billt

    Billt Senior Member

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    I can't even get our insurance to cover it. I think they know once they say YES, it is going to be a huge cost to them.
    So they just let us suffer..
     
    Antares in NYC likes this.
  13. whodathunkit

    whodathunkit Senior Member

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    Everything went up in the U.S. when the "Affordable" Care Act went into effect. Cost of my doctor's visits AND what I paid out of pocket went up immediately.

    "Affordable". Uh-huh.
     
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  14. Antares in NYC

    Antares in NYC Senior Member

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    Just going to say, having experienced the health systems in different countries, that the insurance model in the US is arbitrary, uses overinflated prices, and is prone to abuse and fraud since the ultimate motivation of the system is profit; your health is secondary to the bottom line of the insurance companies --anyone with ME/CFS or Lyme in the USA can pretty much testify to that.
    In this system, the costs for the same procedure can very wildly from one doctor or hospital to the next, and what insurance companies cover seems often arbitrary, sometimes even cruel.

    It always baffled me that the same treatments or procedures in Europe cost a fraction of their American equivalents. Someone is pocketing a huge chunk of change in the process. The whole thing is obscene, imho.
     
    Last edited: Jul 23, 2015
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  15. Antares in NYC

    Antares in NYC Senior Member

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    The goal of the health insurance industry in not to make you healthy, but to cover as little as possible so they have large profit margins. That's how it has been from its inception.
     
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  16. whodathunkit

    whodathunkit Senior Member

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    The insurance industry in general operates on the precept of make the wealthy pay. This is a great theory that appeals to all correctly-thinking people until you start getting into the relativism of who's wealthy and who's not. I have a lot of middle-class friends here in the U.S. who thought the ACA was a great thing until they started getting their new insurance and out-of-pocket bills. "But WE are not the wealthy!" they wail. "That's other people! We're just middle class! It's other people who should be paying these gigantic bills, not us!" LOL

    Anyway, in the United States being generally one of the world's wealthiest countries therefore has one of if not the highest rate of payout. Healthcare companies and pharmaceutical companies gouge in the U.S. because the U.S. customers can and will pay.

    Then there's the fact that your monthly premium also determines what your insurance will cover. If you pay more per month, chances are you are covered for more procedures and more stuff. Lower premium insurance, especially only to the extent required by the new law, isn't much good.

    Further, the private insurance industry doesn't really exist in the rest of the world to the extent it does in the States. There is either government healthcare or you pay out of pocket. Governments WILL NOT pay the rates that are charged to the private insurance companies and privately insured pay. For the most part, private citizens paying out of pocket won't, either.

    However, anyone who thinks that governments are more interested in paying for our health than private companies are is sadly mistaken. Government bureaucrats will throw us under the bus just as quickly as the bean counters at private insurance companies. In private insurance, profit is the motive; in governement, cutting healthcare costs so that bureaucrats can have more raises (that is, so bureaucrats can profit more in their jobs) and hire more bureaucrats is the motive. The end result is the same.

    I don't know what the solution is, but all current systems are dang sure broken.
     
    Billt likes this.
  17. SOC

    SOC

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    :rofl:
    At least my GP treated me with some respect this time and gave me abx after I said the magic word, "hypogammaglobulemia". Much better than my previous $350 PFO experiences when all I had was a CFS diagnosis. :rolleyes:
    The insanely rich 1% who own the insurance companies, the hospitals, and the clinics.

    My local hospital/clinic pays no local taxes because they are, on paper, a non-profit organization. In fact, there are a few people, CEOs and the like, who are making beyond ridiculously large salaries so that the organization can claim they make no profit. One reason my GP visits cost so much is that although the doctor fee is relatively normal, they charge an additional 230% above my doctor's fee as "hospital services" because we used an office in their clinic building. :rolleyes: My insurance company considers this far above fair and reasonable and won't pay it, so I have to. :mad:
    This has absolutely nothing to do with the Affordable Health Act, which made it possible for people who did not have insurance, and whose medical bills were previously paid by charity or by increasing the bills of patients who were paying, to be able to get insurance and pay a part of their own medical bills. Yeah, those people may be complaining that they don't get free healthcare paid for by everyone else anymore, but I don't feel sorry for them. They should be pulling their own weight where they can, just like everyone else.

    The overcharging done by my local medical monopoly has been going on since long before the AHA and is the result of the greedy excessively rich milking the poor and middle class for everything they can get. It's one thing to work hard and make a lot of money. It's another to grossly overcharge people while doing no more work, just so that you can line your pockets with gold because you don't think silver lining is good enough for your oh-so-special self.
     
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  18. SOC

    SOC

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    I had the same problem until my immune system got so bad that they simply couldn't deny it. The insurance company set the bar for getting IVIG higher than any of my doctors do, but once I finally passed even the insurance company's bar, they agreed to pay up.
     
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  19. halcyon

    halcyon Senior Member

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    When the ACA went into effect, I was forced to select a new health plan through my employer at the time. This resulted in a 2000% increase in the cost of my premium for a roughly equivalent (slight worse actually) plan. I still don't understand why this is.
     
    whodathunkit likes this.
  20. whodathunkit

    whodathunkit Senior Member

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    @SOC, I agree with you on most of what you said (the outrageous CEO salaries, etc.). And I don't deny that things were expensive before the ACA.

    And I don't want to turn this into a political debate.

    But I do want to say a couple things before I leave this issue.

    The ACA did NOT make it any easier for destitute and disabled people to get healthcare. Those people already had Medicaid. The hoops they have to jump through are still there with the ACA.

    What the ACA *did* was make it impossible for poor and underemployed people to avoid paying something. For example, that minimum-wage 30 year old cashier who might not want to opt for health insurance through her employer because she'd rather put her scant money towards car insurance or maybe groceries rather than buy insurance she bets she won't need right now? She can't opt out any more. She either buys the insurance her employer offers, gets insurance on a public exchange (which are increasing in cost already), or pays a "fee" on her tax returns for the privilege of not buying health insurance.

    ACA was essentially a tax on the working poor. It resulted in fee hikes for everyone, but the hardest hit are the working poor, who are not eligible for tax-free government benefits and thus can afford it the very least.

    At any rate, take a look at Medicaid and what's going on at the VA right now. That will be the entire U.S. healthcare system in 20 years if not less.
     
    Last edited: Jul 23, 2015

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