Cost of IGg?
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September 28, 2008 at 7:31 pm
I’d like to get some input from other forum members on the cost of IGg. I’m currently receiving treatment at the Methodist Neurological Institute (Methodist Hospital) in Houston, TX. I was receiving the same treatment at the Infusion Lab at the Baton Rouge Clinic, in Baton Rouge, LA, but the neurologist who is currently treating me (and in whom I have complete confidence) insisted that I transfer over to Houston so he could monitor me because of the large dosage (60 gms per day, which works out to 600 mg/kg per day) I’m receiving.
Things have been going rather well. After my last booster, three weeks ago, the neuropathy in my feet was greatly improved for about 10 days, at which time it became severe again. The prior booster had produced only about three days of improvement. My neurologist wants to try 60 gms for one day every two weeks, to see if the improvement will hold, then do some experimentation with frequency of treatment. He and I both agree that we’re searching for the minimum dose and the longest time between doses that will produce the desired results.
This past week, I began receiving bills from the hospital, and Explanations of Benefits from Blue Cross, both of which were shocking to me. The hospital is billing Blue Cross at the rate of $52,000 per day for my treatments. Of this amount, $2,000 is for the use of the infusion center and for care given during the infusion process. The other $50,000 is for the IGg product itself (Gamunex). Blue cross discounts this amount by $20,000 because of their contractual agreement with Methodist, and they are actually paying and have paid Methodist Hospital $32,000 per day for my treatments.
When I got to the point where I could take a deep breath again, I went to the Blue Cross web site and reviewed my prior claim information. I was receiving the same amount of IGg (Carimune) at the Baton Rouge Clinic, and Blue Cross was paying that provider $3,800 per day. I know that different brands of IGg may be priced differently. However, I can’t believe that one brand would be priced almost nine times more than another brand.
In either situation, the cost to me is zero, since I long ago satisfied my annual out of pocket maximum. My concern is for other members of my group. I work for a small company, and there are only about 60 members in our group. If Blue Cross pays out more than $800,000 per year for my treatment, the increase in premiums for the group will be staggering.
Have any of you other members seen billings this large for IVIg? My research indicates to me that the $3,800 per day that I was being billed by the Baton Clinic seems to be a reasonable price for this product.
Comments?
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September 28, 2008 at 7:44 pm
Kevin gets 90, well this month will be 80, and we to are with bcbs. We do nursing care at home for 4 days, now will be three for 6 hours and 40 minutes each day. Blue cross pays out about $17000 total. We have a 5million life time benefit.
Dawn -
September 29, 2008 at 3:11 am
I saw a bill recently and Joshs 5 days of IGg is about $50,000. He has 5 days in a row every 5 weeks.
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September 29, 2008 at 8:49 am
I found this link the other day & posted it. Supposedly this is the cost of IVIG.
[url]http://www.hopkins-hivguide.org/drug/miscellaneous/intravenous_immune_globulin.html[/url]
Here is the chart:
Gammagard SD Intravenous immune globulin (IVIG) Blood Diagnostics IV vial
2.5, 5gm; 10gm $116.60/gm.Gaminume N IVIG Bayer IV
vial
10% 5gm/10ml $101/gIveegam EN IVIG Biomed Plus INC IV
vial
5gm $102/gmGamunex IVIG Talecris IV
vial
1,2.5,5,10,20 gm $104.08/gmGammagard Liquid IVIG Baxter IV
vial
1,2.5,5,10,20 gm $129.60/gmCarimune NF IVIG ZLB Behring IV
vial
1,3,6,12 gm $82.50/gmBaygam IVIG Talecris IV
vial
2mL,10mL $145.65/10mLGamastan S/D IVIG Talecris IV
vial
2mL,10mL $145.65/10mL*Prices represent cost per unit specified and are representative of “Average Wholesale Price” (AWP). AWP Prices were obtained and gathered by Lakshmi Vasist Pharm D using the Red Book, manufacturer’s information, and the McKesson database.
^Dosage is indicated in mg unless otherwise noted.
USUAL ADULT DOSINGAccording to this chart your IVIG should cost $6244.80.
We’ve found that everything is much more expensive at the hospital. They will really nickle & dime your insurance company, especially if you have good insurance. We also have BCBS & have been down this same road. It’s like they see that card & think “cha-ching we’re gonna get paid!”
When Emily was in the hospital & receiving her infusions it would run anywhere between $10,000 & $15,000 per day. She only gets 20 grams Gammaguard. I think they over charged for the IVIG but they also charged $20 for 100 mg’s of Tylenol (which is 1 pill or 1 tsp liquid). It all starts to add up after awhile.
Can you talk to your dr about doing home care? It’s SO much cheaper & easier. If the dr is concerned about side effects let him know that when you do home care you have one nurse assigned to you, instead of at the hospital where it’s one nurse assigned to 5 or 6 different patients. If there are any problems the home care nurse would see them before a hospital nurse would since they can keep a closer eye on you. Home infusion nurses really are more knowledgeable about IVIG because that’s pretty much all they do – that’s their business.
Also, if you do home care they will send a kit over to start an IV with meds in case you do have a severe allergic reaction. Most often if a patient starts to have a reaction during an infusion it’s seen pretty early & can be halted by either stopping the infusion or by slowing it down. Since, like I said before, a home care nurse can monitor you more closely than a hospital nurse can, the chance of severe allergic reaction at home is low.
Anyways, it’s something to consider. It will certainly bring the costs down. Our insurance is being charged about $2200-$2300 each time Emily’s nurse comes. That includes IVIG, nursing charges & supplies.
I’m glad that your dr is being proactive & willing to try a more aggressive approach with IVIG. Too many dr’s are afraid of it & unwilling to try. It sounds like you’ve found yourself a great dr.
Hope that helps,
Kelly
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