Community Forum

Hello,

My son had been receiving remicade infusions from our previous provider at a non-discounted cost of $9,000 per infusion (10mg /kg dosage) for the drug itself.  (discounted cost to my insurance company was $3,000)

Our new healthcare provider charges a non-discounted cost of $18,000 per infusion for the drug itself for the same dosage. (discounted cost to my insurance company was $12,000)

Im trying to assess the long-term cost exposure to my son for having this disease.

what is a more reasonable price for this dosage of remicade?

please advise.

 Reply posted for slisle.

I live in Ohio and am currently on remicade the cost of each trea tment is 8450. my ins is beingc canceled as of sept.30 due to my employers cost. i am a single parent and am not able to afford my treatments.i recently had surgery due to crohns and have been off work also. ive tried to get insurance independant and no company will offer it to me due to my diagnoses. what to do?   

 Reply posted for slisle.

A few years ago I had a snafu with insurance, and 1 remicade infusion fell outside of my coverage.  I now have a lawsuit for 20K owing to the hospital outpatient facility.

If these stories, and the idea of all the costs and struggles for people with Chronic illness disturb you  - please advocate.  For each person that feels strong enough, there are 5 who don't have the energy.  Our current and proposed system of health care in the US does not work, and as shown by car insurance  - simply requiring it will not bring the price down. 

Write your senators and representatives.  Repeatedly.  Let them know that the healthcare they receive for life blinds them to the fact that chronic illness bankrupts us, leaves us with decisions to stop or reduce care, and if we have to reduce work/ self employ or stop working - leaves us out in the cold unless we are wealthy.
please advocate !  Somehow we need to fix our broken system!

 Reply posted for thepworth.

I am in Utah. I don't know if that makes a difference - what state you're in - or not, but I was blown away when I read your post. I was told that Remicade would cost $1,400 for me. That is SCARY enough! Where do they get off charging us a down-payment on a house?! Just so that we have a chance at normalcy?

For anyone reading this without insurance... Remistart only helps the insured, but an application can be filled out directly to Johnson & Johnson for a discount or even for free infusions! I just qualified - via Home Care! If you need to go that route, ask your doc for the application.

 Reply posted for slisle.

I live in "NY and by the time we get done with the infusion at the hospital the total cost is almost $7000. We have a new ins do I don't know what the cost will be. 

 Reply posted for slisle.

I live in "NY and by the time we get done with the infusion at the hospital the total cost is almost $7000. We have a new ins do I don't know what the cost will be. 

 Reply posted for tlw0611.

thank you!

this is wonderful advice.  I'll do some shopping around and post back about what I find.

thanks again.

 Reply posted for slisle.

Your right. I used to work for a Childrens Hospital and they charge alot more for everything than a regular provider due to there specialty and they bill as a hospital charge too to get more reimbursment from insurance companies. Your best bet is to find an outpatient treatment center that is covered by your insurance and ask them what they charge and more importantly, how they bill it to the insruance company. Some bill as a hospital charge which is more expensive or as a clinic charge which is the least expensive.  Its like finding the cheapest pharmacy. Most places are more than happy to tell you what they charge but do ask how they bill it too. Good Luck!

 Reply posted for slisle.

thank you for your reply (i'm no longer eligible for remistart program)

most importantly, i'm wondering about the overall process of healthcare shopping. his new provider is a specialty 'childrens' hospital and that is how they 'justify' their pricing. but it's exactly the same drug so i don't think its really appropriate for them to be charging this high.

i could understand if they would charge more for their service, but not the drug.

so i guess i just need to shop around like i'm buying a used car and see what provider will give me a deal.

frankly, i think they are just taking me to the cleaners because they can!

 Reply posted for slisle.

WOW...mine were 1/2 the cost of your first price.  Luckily my insurance paid all but my deductible.  Also, the Remistart program may help you.  Here is the link.centocoraccessone.com  Good luck.