Remicade cost?

not to resurrect this thread, but I just got new insurance & have had to make a bunch of phone calls for prior auth's & referrals & such. I spoke with the billing department at the hospital where I get my infusions, to give them my new insurance info, as I have an infusion scheduled next week. I asked them the total cost of the previous infusions- $11,300. $10,151 of that is the Remicade, the rest of the charges are the infusion charges. That's a lot of money......I can only hope my new insurance is as good as the last ones I've been covered under.

well, I first have to call my PCP to get the referrals to see my GI (whom I've been seeing for 2+ years...). I had a bunch of referrals under my old insurer. Then, my GI's office does the calling to get the prior auth's & such, but I have to speak to the lady there who deals with Remicade & insurance- they have to submit a bunch of ppwk. & they need my new insurance plan info. And I called the hospital where I get the infusions to give them my new insurance info, so they can bill the correct insurer. I guess it's not toomany phone calls- just seems like it!

as long as they keep shelling out the $$$, I don't mind doing a little legwork to get it! Besides, I make all the calls from work anyhow.....

I just found this thread and read it with great interest.

I've been taking Remicade since May (Bekhterev) and got 4 infusions so far.

Each visit costs me 100 Swedish crowns, aprox $15 USD. That is on the
public insurance system that everyone is entitled to. Life-long if needed.
And that cost is not for the treatment as such, it's more of an "visit-fee".
The Remicade threatment as such doesn't cost (me) anything, even
if life-long.

There is also a limit of 1.800 SEK (aprox $300 USD) over each 12 month
period for *any* medical treatment what so ever. No matter what you need.
Well, I kind of like our system (even better now, efter reading this thread... ).

Post Edited (Swed_guy) : 8/2/2011 1:18:03 PM (GMT-6)

My son gets his infusions done at a Rheumotogolist's Infusion Center. This particular rheumololgist treats pediatric patients and oversees their REMI infusions (full time nursing staff oversee the infusions). My son's GI referred us to him vs. going to the hospital, specifically because of the cost. My son recieved his first three "loading" doses of Remicade at a cost of $5280.00 just for the medication. Thankfully, I had already met my "out of pocket" max for the year of $6000.00. It was covered 100%. I also just received the first bill from the Infusion center who administers his Remi. $375.00 for each visit. A HUGE difference from what the hospital charges!! I would highly suggest that anyone out there receiving infusions, look into the option of going to an Infusion center vs. the hospital.

To: Finney56... my insurance would not cover Remicade through Medco. It was not covered at all through my pharmacy plan....however, it was covered under my Medical coverage. And my doctor told me that they HAD to cover it under medical if the doctor advised that it was a required treatment. I would advise your sister to check again with her health insurance. I have UHC and they are a nightmare to deal with.

Now it will be interesting to see what the insurance charges for the next round of treatments.

Best wishes and good health to everyone !!

Goto Walmart Super Pharmacy, online or by phone. They sell 4 units of Remicade (enough for a 160lb person), at $2854.36. They will drop ship it (overnight, cold) to your infusion center or local medical provider, directly. This way you can get rid of your provider's ridiculous overhead charges, which otherwise will run you $5000-$10000.

If you are interested in current costs of Remicade, here is what I got from my research this past week:

CPT Code_____Description________Cost
n/a__________Saline Injection_____$ 24.00
n/a__________IV Pump/filter fee___$151.00
96413________Infusion 1st hour___$258.00
96415________Infusion 2nd hour___$ 93.00
J1745________Injection, Infliximab‎__($2,500 per vial of 100ml)X 3 vials
-Grand Total-----------------------$8,026

I weight 132 lbs or 60 KG. For each KG of body weight I would be given 5mg/ml. Each vial contains 100 mg/ml of medication. So it would be (60X5)/100=3 vials amount would need. They always round up, so if I weighted just slightly more then I would need a fourth vial.

The Remicade/Infliximab is mixed within an hour of you getting the shot, as it breaks down and cannot be stored. So any waste is just that, waste, and is disposed of; one very expensive medication going down the drain or whatever they do with it.

What is it like to take a drug that ties you down geographically, I mean did you ever want to travel abroad for more than 4 - 8 weeks?

For me, this is one of the strong reasons that i'm so opposed to starting Remi. The other meds taken orally, what I have done in the past is ask my pharmacy to give me in advance a few months supply (they have my credit card just in case...) and they bill the insurance as the months come, and if i'm going for over 4 months, someone in my family can send it over with a friend traveling there etc. However with Remi i'm sure this not possible to do. And getting the med abroad would run me $6,000 (at least) per infusion...

It depends on where you recieve the infusions. Hospitals are a lot more because of the increased overhead. It also depends on how much you recieve.

Mine is done in a doctors office that specialises in arthritis. I recieve 500 mg and it cost $5000 for the medicine, $200 to administer it and a needle puncture charge. Total cost is like $5500. It is sometimes given with sulfazine (which I take 1000 mg twice a day). It is also sometimes used with injections of kenalog and Toradol. I have had these also. 60 mg Toradol and 40 mg kenalod. Toradol is an NSAID and Kenalod is a steroid.

It works very well.. I now have an active lifestyle. Before I started the medication I was basically recliner bound.

Your high cost could be a higher dose or hospital. You might look for a doctor that specialises in your disease and see if they do it in their office. My Dr has 8 chairs. it takes about 1 1/2 hours for the infusion. So the chairs are revolving every 1 1/2 hours. She starts at 9 am and ends up about 2 pm. she only does it one day a week.

Post Edited (frankraney) : 8/29/2016 10:22:29 AM (GMT-6)