Meds: Is our insurance company ripping us off?


#1

Hey Everyone,

I have a question about meds. We have coverage for our meds - but are capped at $7500. We’ve so far spent $2300 so we have about $5200 left. We thought that would be plenty to cover our meds for one IVF cycle, but our insurance company is quoting us at more than 6K. Are they ripping us off? I’m not on a lowest dose of meds, but I’m not on an extremely high dosage either? Here’s what I’m on:

300 IU Follistim (10 days)
150 Menopur (10 days)
Ganirelix (sp)
Ovidrel
Progesterone suppositories

Most things I’ve read said that -at most - IVF meds will be around 5K. At these prices, Follistim by itself seems to be more than 3K.

Does this seem reasonable? What do other pharmacies charge? Are there cheaper pharmacies out there if we have to do this again and are all tapped out of insurance $?

Thanks,
Ruth


#2

sounds right to me


#3

Sounds about right to me as well. I know many ladies on here paying out of pocket between 5-7.5k for meds


#4

This sounds about right to me. It’s hard to compare between women, as our doses can be different. So some women might need to order twice as much Follistim for example. I’ve heard $5000-$7000 is an average.


#5

My suggestion. Don’t order it all at once, many times they lower your dose mid way and you could be left with some medicine. I order my pens one at a time on the Gonal F.


#6

I spent about $2,800 total on all of mine (Lupron, Gonal-f, Menopur & PIO). However, I was on pretty low dosages - 37.5 IU Gonal-f (lowest dose) & 150 Menopur (2 vials) for ten days total. The Menopur by itself was $2,000! As for the Gonal-f, I only needed one 450 pen, where as, you are going to need 3-900 pens and 1-300 pen if you end up taking 300 IU a day for ten days. I agree with DRB, you should purchase one to two pens at a time, so you don’t end up having extras left over.


#7

I get my meds from apothecary shops. My meds were just under 6000.00 for the antagonist cycle, this is what I got for my 6k:

Follistim 4500iu (450iu/day)
Menopur 4 boxes (150/day)
Ganirelex (4 doses)
Ovidrel (trigger shot)
Dexamethasone (steroid)
Doxycyclene (2 bottles antibiotic for me and DH)
Provera
Baby Asprirn
Tylenol w. Codeine (just in case for after ER)
Lidocain Cream (numbing cream for PIO)
PIO (4 large bottles)
Vivelle Dots (estrogen patches, 40 patches)

My insurance actually covered the PIO, Doxycyclene, Tylenol, Aspirin, Lidocain, Vivelle ($10 copay for each).


#8

I could see that being in the ballpark. I’m on about the same dosage as you – 300 IU Gonal-f + 150 IU Menopur. No Ganirelix. My meds are about $4000, but that’s for only 8 pens of Gonal-F. The pens were $500 each, so if they’re looking at 10 pens (figuring average stimming of ten days), that would be another grand. You might be able to get them for a little less at another pharmacy, but I’d guess it will still be at least $4000-4500 (which I know is still significantly less than 6k).

I used Freedom Fertility Pharmacy, whom I’d always heard was reasonable. This thread has a couple of other pharmacies mentioned that seem to have even lower prices: http://forums.fertilitycommunity.com/vitro-fertilization-ivf/2020195043-medicines.html


#9

It does seem a little high to me. I used Walgreen (schreft’s) Pharmacy and Freedom Fertility Pharmacy (both in the States) for my first cycle and spent closer to 5K on my first cycle - I was on the same dosages as you. They’re both specialty pharmacies for fertility treatments. For my 2nd and 3rd tries I smartened up and used IVFMeds.com out of the UK and saved over 1/2.

Here’s approximately what I spent:

300 IU Follistim (13 days) - about $3200 - You definitly get extra out of the pen, no need to extract like Gonal-F
150 Menopur (13 days) - about $1600 - Keep in mind you’ll likely use 3 vials instead of 2 once you start ganerelix
Ganirelix (sp) - $380 for four days
Ovidrel - $40
Progesterone suppositories - don’t know, used projesterone in oil injections at $28/vial (lasts about 10 days).


#10

Insurance company pharmacies usually are more expensive than other pharmacies. We learned that when we had to pay out-of-pocket for our IUI drugs but were covered for IVF drugs. However, you usually have to use the insurance pharmacy if you want them to cover you.


#11

I just purchased, out of pocket, a 900 Follistim cartridge for $720. That’s two days for me, and yes there is at least 100 more units in there…since I’ve been a very slow responder, I’ve been giving myself a lil extra.


#12

You can always ask your RE office if they have meds that were donated from other women. I have a lot left over and plan to donate to my re office.


#13

I had the same meds you listed but a higher dose of Follistim. I was taking 450IU a day. Four boxes of Follistim 900IU = $3048. All my other meds combined were $500 - this included menopur 75unit vials x 4, ganirelix 250mg x 2, novarel 10,000 units, progest ethyloleate x 4, estradiol 2mg x 20 and diazepam 5 mg - 1 pill. The follistim is over filled but each bottle had different amounts so dont rely on an additional 100IU in each vial. Our insurance does not cover IVF so we paid out of pocket. Unfortunately I did not have a good response to the Follistim so our cycle stipped. We are hoping to try again in January.

Good luck!


#14

Thanks!

[FONT=Verdana]Thanks for all your replies! I guess the price of medication is a concern all of us have. It is so darn expensive! I talked to our insurance yesterday and they said that insurance-paid drugs are usually more expensive…so we’re going to get what we can from them and then go somewhere else for the stuff we need to pay out of pocket. And thanks to you all, we know have lots of places to chose from. Thanks and good luck to everyone![/FONT]