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Remicade cost?

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Posted 2/12/2008 11:04 PM (GMT 0)
Do any of you know the specific cost of your Remicade infusions?  I had never seen billing info for any of my previous infusions, but for some reason the insurance is not covering it fully this time.  The bill from the hospital says it was almost $12,000. 

I know that Remicade is expensive, but I thought that the cost was in the $1000-$3000 range.  I want to pursue this with the hospital, but I would like to have some supporting data. 

Thanks.   

Posted 2/12/2008 11:12 PM (GMT 0)
It would depend where in the world you are. I am guessing you're in the US somewhere?
Posted 2/12/2008 11:19 PM (GMT 0)
Depending on the dose and costs charged for the infusion, it will vary. Mine runs between $7000 and $8000 for an infusion, including everything. Still cheaper than surgery.
Posted 2/12/2008 11:27 PM (GMT 0)

Yes, I'm in the US. 

I am receiving the standard dose.

I think the grey area here is the "costs charged for the infusion" line item.  They are nice to me at the hospital, but they do not provide a service that is worth $5000-$10,000.  If that is the case, I'm going to dispute this. 

Posted 2/12/2008 11:42 PM (GMT 0)
I'm not sure what my dose is, but last time I was in the infusion clinic I asked the nurse how much the infusion was costing and she told me $4,000. I don't pay a sent, not even a copay. I feel very fortunate, but also nervous -- if my husband's employment situation changes I doubt I'll ever be able to get insured again (I am self-employed). My other meds are costing my insurance company at least $1,000 a month, my copays are $5, $10 or $25. It depends on whether generic are available or what "tier" the insurance company considers the drug.

Meesh
Posted 2/13/2008 1:38 AM (GMT 0)
I get mine in the doctors office - total cost is about $2500 - $3000.  I pay 20% which is usually about $500 per infusion.  Well worth it.

Posted 2/13/2008 3:17 AM (GMT 0)
That does sound a little bit high but I'm assuming the hospital is charging you for the Remicade drug and the infusion costs. I think my hospital charges about $500 per infusion. Caremark ships the Remicade to my hospital's pharmacy. I think it's around $4,000. Not cheap!
Posted 2/13/2008 3:43 AM (GMT 0)
I process medical claims and the Remicade I've seen seems to run from 7000 to 13000
Posted 2/13/2008 2:50 PM (GMT 0)
There is a program called Remistart, that provides rebates for eligible participants. Our papers say to call 1-888-222-3771, and say youu wish to enroll in the Remistart Program. My son has not started Remicade, so we have not done it yet, but just throwing the info out there.
Posted 2/13/2008 3:33 PM (GMT 0)
It was around $10,000 for my Remicade.
Posted 2/13/2008 6:49 PM (GMT 0)
barbl, please share more about your knowledge of claims.  Does anyone question the significant difference in cost?  You have seen costs range from $7000 to $13,000.  Why would you accept a bill of $13,000 from one hospital when another charges $7000?  Others here have stated that the cost is as low as $2000.  I would like to understand this huge variance in cost. 
Posted 2/13/2008 7:54 PM (GMT 0)
I went back and rechecked. The infusion center bills $10,000 for everything now. The insurance actually pays just under $5000. Some of the cost is for the use of the center, the equipment and the staff to monitor. Also, the number of vials of medication used can vary greatly because of body weight and that has a pronounced effect on the charge.

I noticed that after I lost about 5 kilos (a little over 12 pounds) it took one less vial to infuse me. I'd suspect body weight of people on this board varies by as much as 50 kilos from lightest to heaviest; this would be huge difference in the amount of the drug needed.
Posted 1/8/2009 11:02 PM (GMT 0)
My sister works for Northwest Airlines she has for around 20 years, 17 years ago she found out she has Rheumatoid Arthritis at the age of 33. They tried different types of drugs to ease her pain and stop the joints from deforming, but nothing worked. She was a very athletic person who is in great shape but was deteriorating in front of my own eyes. Then her doctor tried a new drug and it worked so well that she was not confined to bed or a chair and feels pretty good most of the time. The drug is Remicade and she needs infusions every 6 weeks, but of course this drug works so well and people need it to feel normal, costs an outragious amount of money 12,000.00 every 6 weeks. Colleen has insurance through Northwest and it was working out good every 6 weeks go get her infusion and feel great working 40+ hours a week and tried living a somewhat normal life with this painful disease. Then January 1st, 2009 comes around and Colleen is grocery shopping and gets a call from the doctors office they tell her that she cannot receive her infusions any more that her insurance would not cover it. Medco denied the infusions from her Rheumatoid doctors office and said that she could be shipped the Remicade through the mail and that would save the companies alot of money. First of all noone will come out to her house for free and hook her up the the infusion. Second of all I know that she needs her medicine because without it she will not be able to work or take care of her family or for that matter walk!!! I am just irritated with how people that are having alot of trouble dealing with these horrible, painful diseases and then they have to go through this crap with the insurance. I work with a girl that has her medicine shipped to her address every month and has a problem dealing with Medco every time. How can they be saving money when obviously people will not be able to work if they cannot get the medicine that works for them.
Posted 1/9/2009 2:20 AM (GMT 0)
I get a infusion every eight weeks through Walgreens outpatient clinic, the remicade depends on your weight for me I'm 6'3" 225# they charge $300 for the remicade its self and $3600 to administer it! outrageous!

Check with your insurance co. because they agree to a lesser amount and the clinic or hospital my be charging you the difference. They want to bailout these auto maker and financial companys how about doing something for people with medical conditions that we did not ask for, one bad medical problem could leave you bankrupt.

 

Posted 1/9/2009 2:59 AM (GMT 0)
And these are the first drugs that are usually limited in government health programs. Our UK members tell us Remicade isn't available for maintenance therapy, only in short courses.

$4000 for a Remicade infusion is a real bargain, by the way.
Posted 1/9/2009 3:28 AM (GMT 0)
Charge is near 10k per infusion--this includes the hospital session monitoring at the University of Chicago, Comer Children's Hospital. It does depend on your dosage for the actual medicine charge.
This drug is not formally approved for children, so the insurance co. automatically denies the claim. We are luck to be in a trial, so the costs are covered, for now....
Posted 1/9/2009 7:53 AM (GMT 0)
Just a question for all of you on remicade, is its main effect with the immune system? And do you always have to go to a doctors office or hospital to get it?

--------------------------------------------------------

yuckygut

diagnosed 1998

now off prednisone and colazal

drink 1 Haldi daily to remain in remission
Posted 1/9/2009 2:23 PM (GMT 0)
Remicade is given by IV infusion over a 2-3 hour period. Because it occasionally (as with any other infused drug) can cause serious allergic reactions, it needs to be given under supervision and with emergency equipment available. Therefore, in a doctor's office, infusion center or possibly by a home health nurse (although I suspect not many agencies would be willing to do it in home.) This is one of the factors that increases the cost so much.

Remicade is an anti-TNF blocker. It works by blocking a specific component (tumor necrosing factor) in the immune system. This is probably why there is a small increase in the risk of certain kinds of cancer from taking Remicade. Humira, Enbrel, Orencia are in this same group of drugs.

There's no question Remi is a serious drug, and people should weigh the pros and cons before taking it. But for those of us like me, who flared for more than 4 years with no relief, it can be a godsend.
Posted 1/10/2009 1:54 AM (GMT 0)
I get an infusion every 8 weeks at a local hospital.
$5OO,for the infusion
$4500,for the Remi...
More than I make in a year...
Wow!(I'm lucky)
Posted 1/15/2009 10:58 PM (GMT 0)
Remicade (Centacour) has a Patient Assistance Program whereby they will pay for the entire drug, or possibly your copays.  When my husband first started on Remicade, it was not yet approved for his type of Arthritis so Our insurance would not pay anything on the drug.  The Infusion center suggested we apply to the Patient Assistance Program.  We had to include insurance info and income information.  We are not rich by any means, but we make decent money.  I really did not figure it would do any good.  But we applied anyway and they provided the drug free of charge.  All we had to do was pay our coinsurance for the infusion.   There are also some rebate programs as well. 

Go to the Remicade website for more info.  Or call 1-888-222-3771 (ACCESS ONE) and tell them your situation.  They will help you proceed.

Posted 1/19/2009 1:20 AM (GMT 0)
Jeez you guys are cheap. I go to a hospital in Westchester, NY and it costs about $26000 but I believe my insurance pays about half. No copayment thank God.
Posted 1/19/2009 1:34 AM (GMT 0)
My remi nurse said something to me about there being an option for people to go on medicad if there insurance doesn't cover it. She said then they have to go to the hospital instead of the remi center(were I go) and then it costs more because you are in a hospital. I'm not sure why.
Posted 1/19/2009 11:47 PM (GMT 0)
My doctor's office called me today and said the infusion center they were going to send me to is not in the network so I had to find someplace I could go... It looks like my option is this cancer center unit in one of the in network hospitals. Does anyone else here go to a cancer center for their treatment?
Posted 1/20/2009 2:58 PM (GMT 0)
I don't go to a cancer center, per se, but I do go to an infusion room in a hospital, which is in my network. They administer chemo drugs at the infusion room, as well as any other IV drugs that need to be administered. And my hospital bills my infusions as chemo. Which enables my insurer to cover them in full- if they were billed as Remicade infusions, I'd be liable for at lest $250 per infusion. This may be a good option for you, insurance wise- most cancer treatments are covered in full by insurance companies.
Posted 1/25/2009 11:09 PM (GMT 0)
When I was receiving remicade at my doctor's office in Texas I didn't have to pay anything, but  when I moved to California and my doctor didn't do infusions in his office I started getting the infusion at an infusion center.  Because I now get them at a "facility" I was told that the cost jumped from $3000 to $16000.  My out of pocket now is 10% rather than the $0 it was before just because of where I am getting the infusion.  The irony is that I am getting the infusion at a teaching hospital so I am being charged much more to have a med student administer my infusion rather than an actual doctor.

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