Anyone else's neuro billing $4K per infusion?!

A board to discuss the newly-released drug Tysabri, (formerly known as Antegren) as a treatment for Multiple Sclerosis

Anyone else's neuro billing $4K per infusion?!

Postby flora68 » Mon Jan 31, 2005 12:29 pm

...Ok...so my best friend, just heard from her dr's office today, and they are telling her that the tysabri treatments are $4000.00 a month, now what is going on with that?..... (from Peggy, who's trying to help her friend)


I also posted a message on the Cost thread about getting the same "revised" price of $4,000.00 from my neuro's office. $4K per infusion sounds crazy (is crazy), but it is not a mistake, believe me!

... turns out the doc was mistaken about the cost....he'd quoted the $1,800 per treatment figure after I'd mentioned to him that I'd heard Tysabri would cost over $2,000-$2,500 per month. I remember he sounded a little frustrated that such "rumors" were rampant.....I finally got the call from his office...the Tysabri was authorized by my insurance.
Bad news; it's being billed at $4,000.00 per treatment , not $1,800.00! (from me, flora)


OK, so I know I'm not the only one who's been quoted a firm price of $4,000 per Tysabri infusion 8O . Anyone else so far, besides Peggy's friend and myself?

I can't quite get over the fact that billing $4K per infusion means that, after paying $1,800.00 for the Tysabri itself, the doc is charging $2,200.00 for the procedure itself.

That must be one heck of an IV! I mean, for $2,200.00 do they fly you to Vegas for the infusion? Will there be celebrities, champagne and strippers? Sheesh! :roll:

I declined, by the way. (I take the ridiculous price as a sign that I should be on LDN, which is what I really wanted in the first place.)
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Postby HomeIVProvider » Wed Feb 02, 2005 3:41 pm

You have to find out if he's buying it for the 1,800 and marking it up
or buying it for less and making a huge profit.

If he isn't getting it from a provider that can get it cheaper, he may be paying a steep price for it
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cost near $4k could be right

Postby batpere » Thu Feb 03, 2005 3:53 pm

I asked the infusion center who will be doing my first one next week about
the cost for others that had been getting Tysabri, and they said it was
around $3500. We'll see when the EOB comes through. No wonder they
were so eager to help get me started!
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Postby flora68 » Fri Feb 04, 2005 9:08 am

:|
Last edited by flora68 on Wed Feb 09, 2005 3:20 pm, edited 1 time in total.
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Postby HomeIVProvider » Fri Feb 04, 2005 9:47 am

I know this won't go over that well, as a provider we do strive to provid the best possible care for the least amount of money needed.........on that note, when you consider the costs involved in the infusion, the pay for staff, the supplies you need to give it and also to have on hand for reactions, the time involved to do billing and the back and forth that you sometimes have to do with your insurance etc. , in our case we deliver personally, so you have to consider costs of gas, insurance, and again
the time involved to personally take of your customer, some times the cost can get up there.

It comes down to a very simple question, what is the cost of a better
quality of life with this drug if it really does what it says it does??
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Postby flora68 » Fri Feb 04, 2005 1:39 pm

:roll:
Last edited by flora68 on Wed Feb 09, 2005 3:23 pm, edited 1 time in total.
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Postby HomeIVProvider » Fri Feb 04, 2005 2:14 pm

I recently had a inservice with Lisa Pethen, a Senior Infusion Specialist at Elan and she stated that "infusion in the home care setting is not contraindicated" and "it is up to doctors discretion" so if you and your doctor and a local home health agency would agree you could do the infusions at home after a initial one at a hospital or such and save alot of money compared to doing this at a clinic or say a hospital. You would just need to find a infusion company in your area that could provide the medicine to the home health agency.

Just a thought, a alternative to going to a clinic is always better for you and your pocketbook!!

Any questions you have you can e-mail me at VitalCareHomeIV@hotmail.com
My business e-mail is VitalCareHomeIV@hotmail.com, anyone in the Owensboro KY area feel free to mail me. I'd love to meet some of you!!
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Postby HarryZ » Wed Feb 09, 2005 7:05 pm

I certainly don't disagree with your assessment of the costs involved in performing an infusion. My wife, who has MS, worked in hospitals for years before having to quit due to MS. She has made me very aware of what the costs can be.

What kind of "irks" me is that Biogen initially released the cost of Tysabri to be about $ 1800.00, stating this to be the wholesale cost of the drug. Now how many people out there would have any idea what that amount would translate to when it came to the final cost of an infusion? Now we are hearing anywhere from $ 3500 to $ 4000!! Biogen would have known exactly what the final costs would be but publishing that is not part of any marketing/sales plan. The cost virtually doubles and that is not good promo!

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Postby batpere » Thu Feb 10, 2005 6:11 am

HomeIVProvider wrote:I recently had a inservice with Lisa Pethen, a Senior Infusion Specialist at Elan and she stated that "infusion in the home care setting is not contraindicated" and "it is up to doctors discretion" so if you and your doctor and a local home health agency would agree you could do the infusions at home after a initial one at a hospital or such and save alot of money compared to doing this at a clinic or say a hospital. You would just need to find a infusion company in your area that could provide the medicine to the home health agency.


The nurse that gave me my first Tysabri infusion asked if they could leave it at the door if I was not home (NO WAY!) and then asked for neighbors they could leave it with. Said she was getting the info for what they figured would be a couple of months until it could be offered at home. She did say the nurse would have to be present at the home the entire 2 hours.

I have a friend who is an emergency room physician and also has a partmership in a urgent care center on the side. I know him fairly well and have gone to his home several times for help outside of office hours. Any thoughts on how much of a favor I would be asking for to see if he would oversee the infusions once a month? Major imposition, really not much, or somewhere in between? Or would that not even be a possibility? I'd trust him with my life.
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Postby HomeIVProvider » Thu Feb 10, 2005 10:37 am

First of all, their are companies doing this infusion at home RIGHT NOW, it is just up to you and your doctor(if he agrees to it) Also any infusion company that wants to leave any drug, let alone
a drug that has to be infused within 8 hours after mixing, i would stay far,far away from. Alot of companies even will use FedEx or UPS to deliver meds, don't get me wrong i use FedEx and UPS all the time,
just not for the distribution of my drugs. You should ask any infusion
company what their policy is on this, whether its my company or any one
that you may choose.

On that note, if your physician friend does have a urgent care facility, i personally don't think it would be too big of a imposition to do this once
a month, really who you need to get friends with is the nurse who will be present for two hours that may possibly be on her own time.

They will have anything you would need for any reaction that may happen,
plus a physician right there with you would be a huge plus.

I'd say go ahead and ask!!! All that can happen is that he will say no.
My business e-mail is VitalCareHomeIV@hotmail.com, anyone in the Owensboro KY area feel free to mail me. I'd love to meet some of you!!
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