Thursday, June 25, 2009

The Ridiculous Cost of Neulasta

OK, I'm very, very confused, shocked, and quite frankly, disgusted.

I just received a statement from the Masonic Cancer Center. You know, one of those things that they send that tell you how much everything costs and how much your insurance paid towards it. Through an insurance snafu, it appeared that I did not have coverage for the month of June when, in fact, I did. Because of that, MCC is sending me a bill for my last chemo treatment and the Neulasta injection. That is not what is so shocking (as it will be straightene
d out on Monday and I shouldn't have to pay anything). What made me choke on my own spit was the price of the Neulasta: $7618.00. PER INJECTION. The cost for one injection is more than all of my chemo, which they charge per drug as well as a charge for putting each of the drugs into me. That's not the part that DISGUSTS me. My insurance recieves a discount of almost $3000.00 on the Neulasta, as well as a discount on all other services! Now, I knew this discounting was a regular occurence. What disgusts me is that while Medica receives this great discount, someone without insurance (assuming they would even be able to AFFORD these treatments at all) would have to pay the full price for everything (and I can see this because that is what my current bill states--and that is the price I would have to pay if I were not insured). ARE YOU KIDDING ME?!?!!? So, you have cancer, and if you're not insured but can still somehow afford the treatment, you have to pay full price while the insurance companies get this cushy discount? Why don't they just poke you in the eye with a letter opener and get on with it?

My first question: why on earth is Neulasta so ridiculously expensive? I know it's a very powerful and important drug, but if my insurance didn't cover it (and many people's insurance won't) I would have to suffer with low WBCs, postponements in chemo, and potentially life threatening infections because there is NO WAY I could afford a student, I don't even make that much in a year from working. And yes, as a student of the medical sciences, I realize how much research and manpower goes into the development of these drugs. I know the drug companies have to make that money back for their investors. But, really? Seriously???

My second question...what makes the insurance companies so special that they receive a discount while Average Joe without insurance is stuck paying retail price for something he needs? What kind of screwed up healthcare system do we have that this is allowed to happen, and no one says anything about it? I don't know a lot about the way health insurance companies word, but I do know the basic premise on how insurance works: it's all about balancing risk. There are thousands of people who are considered "low risk" that, to make things really simple, are paying for the people who are "high risk." That is how insurance companies absorb huge catastrophes. But it definitely doesn't seem fair at all.

The total for ONE TREATMENT is over $10,000. Actually, it's closer to $11,000. That doesn't include oncologist visits at almost $200.00 per visit. Multiply that by twelve (because I received twelve treatments), and the onc visits by eight. Give up? $133,600.00. That's almost as much as I paid for the house I bought a few years ago. I can't imagine what someone without insurance must go through to try and make the decision to either be treated and end up with that much debt, or not be treated because they can't afford it. If I were not insured, my decision would come out of necessity: I would not be treated because frankly, I can't carry that kind of debt. It would ruin me financially for the rest of my life.

OK, I just had to rant about that for a bit.

Ted will be home on Saturday. It will be nice to have him back. Today, I went to help out with the field biology class trip (the stuff I normally do). It was fun, even though it was HOOOOTTTT! It touched 90 briefly today, but it's been in the upper 80s for the most part.

Last weekend, I went up to the Disabled Veterans Rest Camp (where Ted is doing his two weeks) for their barbecue. I was able to meet some of the people in Ted's unit, and everyone seemed very nice. I was also able to see one of my good friends Cody, whom I haven't seen in a long time. It was nice to just relax with everyone in that beautiful camp, and to catch up with my friend.

Well, I'm going to go ponder our healthcare system over a Gatorade. I hope everyone is doing well and staying cool!!


  1. Hard to believe the price ....

  2. Good grief, that just gripes the hell out of me too!

  3. This comment has been removed by a blog administrator.

  4. laura wallace-rhodesOctober 11, 2009 at 9:32 AM

    I recently received my first Neulasta shot and my insurance was billed $4,100 - more than the Taxotere (chemo infusion) I receive every three weeks. They settled at $3,500. I too am shocked that those who are uninsured or under-insured are on the hook for this. What is the matter with our system? Who do you blow the whistle to? Is anyone ever going to do anything about this? Cancer is such a big business. I have Metastatic Breast Cancer, so I am looking at a continuum of high cost treatment. I got the stats on breast cancer - 190,000 people have been diagnosed in 2009 - 40,000 will die of this. The 150,000 who are lucky enough to surive will be paying thousands of dollars for treatment. What do we do about this? I am really angry. Thank you for sharing and doing the math. Laura

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  6. Hey Nicole...I was diagnosed December 9, 2009 with Hodgkins and have undergone 3 chemo treatments. I have insurance but it is really crappy, bare-bones insurance (through my employer) and I too am struggling with the seemingly ridiculous cost of Neulasta. I have to get a shot EVERY time I have chemo (once every other week) but the kicker is, I only get THREE office visits per year with my insurance. Yes. Just three. And I just found out today, finally, after two months of not getting a straight answer out of my insurance company that chemotherapy, because it is performed in my doctor's office, counts as an OFFICE VISIT! So, I have untold chemotherapy treatments to go and am now, because my 3rd visit was up on January 29th, on the hook 100% for anything that happens during the doctor's visit: that's my doctor's fee, labwork, chemo and then, the lovely Neulasta shot - every two weeks.

    My doctor has me now scheduled to go to the hospital to get my chemo, my 4th treatment is tomorrow morning, so that it can be considered an "out patient procedure" because my insurance will (or should) cover either 80 or 70% of the cost. I PRAY PRAY PRAY PRAY PRAY that they will also administer the Neulasta shot next Monday so that, too, can be processed as an out-patient procedure so I won't be responsible for the full negotiated amount of $3,100 every two weeks! (btw, I checked at my local pharmacy, to see if I could buy the stuff on my own for cheaper than the $4,200 my oncologist's office was submitting to insurance, and they told me the cost was $7,793 - so yeah, it looks like insurance is offering a sizeable discount).

    Now, you may also find it interesting that the makers of Neulasta offer a plan to help people pay for this drug they obviously know is prohibitively priced. To take advantage of the plan, you need to be insured (but not by medicaid or other gov't insurance), and make less than a certain amount of money. As it so happens, I make $2,000 more a year than that cut-off. While they don't ask for documentation in proving income, I feel (and know) that it would be lying to simply "say" I make less than I do, so I have opted to not participate in their program.

    At any rate, I am looking at a mountain of bills and this dumb shot is going to be the bulk of it all.

    Anyway, I am glad someone else feels my frustration and can understand the absolutely stupid cost of this drug.

  7. I just received a bill for $8,130 for a single shot of Neulasta. They expected me to pay for this out of pocket and they didn't tell me anything about the cost before hand.

    1. In Alberta,Canada a single 0.6 gm injection of Nuelasta is about $2800.00 Canadian or about $2,700.00 U.S.!

  8. When I had Neulasta in 2007, it was $23,000 per shot that was billed to my insurance. I had 11 of them, it was nearly half of my entire treatment cost including all the surgeries, for treatment of Hodgkins Lymphoma.
    If you have crappy insurance talk to the business office of your doctor to find out if they offer any kind of charity care. My doctor's office covered all of my out of pocket expenses that were incurred in their clinic outside of what my insurance paid.

  9. When I was on Neulasta I had to sign a special contract agreeing to be held responsible for payment if my insurance company disagreed... which I was assured they wouldn't but I was willing to go into debt for a trillion dollars to survive after all, since I had a pre-teen daughter at the time who thought I would live forever.

    Now she's still pre-teen, 11, and I'm cancer free - not remission but free (I count officially since my chemo ended in June of 2009) since they cut off the cancerous limb completely, the chemo I did for 6 rounds was palliative / prophylactic (love throwing around those big a$$ words). I love this post! I felt exactly the same way about the exhorbitant cost of neulast a which was the second most expensive individual thing I got the most expensive being my $75,000.00+ prosthesis which now gathers dust in the closet of my bedroom -- cannot find a pt anywhere who has any experience training a hemipelvectomy survivor and I've been from Orlando FL to Baltimore MD looking in person.

    OK now back to my Neulasta rant. I had to leave my job where I had the kick-butt healthcare, and as part of my separation, since I left on the best of terms (it was literally political in nature where I worked... I will only give the initials of the fine organization located in Washington, DC, those initials being DNC... they later fired almost the entire Technology department to bring in their own staff from the campaign), they gave me an offer of 2 years of free healthcare and since I was in year 2 and 10 months of cancer free-ness as of the offer date, you can believe I took that offer!!!

    As far as I understand, Obama's healthcare mandates start kicking in in 2014 which is right around when my healthcare expires. I am really unable to work fulltime anymore since I experience chronic fatigue and pain... so I am going for the disability route which I expect to get due to the severity of my amputation (hemipelvectomy completely removed my right leg plus about 10 percent of my pelvis), but wow what if I need chemo for metastasis or even an unrelated cancer (not getting any younger)? Oh my God. Will Medicare cover it? Medicaid in my right wing state of Virginia??? Here's hoping Obama's healthcare will render these concerns "moot" since Neulasta will be covered for everyone equally.

    The thought of tying life-saving healthcare to where you work or attend school, etc... who came up with that hair brained idea? Sheesh can anyone say 19th century? Lets truly hope things will change for one and all in this otherwise amazing country known as USA.

  10. I guess it helps to know people, even "out of the blue!"
    I have stage 2 lung cancer, but fortunately, my two surgeries in the past month took care of the malignant tumor!
    Tomorrow afternoon, I will have my first (of four) preventative chemo treatments...spaced once every three weeks.
    I received a call last week from a person (call him John Smith) I briefly met a year or so ago, a good friend and former co-worker of my younger sister.
    My sister is in the medical field (assistant purchasing director of a health care system) and John, unknown to me until last week, works in some capacity at the Oncology facility (where) I will receive my chemo treatments.
    John's phone call was to let me know "that I was selected" to receive a free Neulasta shot along with my first chemo treatment and that I would be charged $25 per shot for all future treatments. I simply need to sign a form tomorrow when I arrive for my appointment. (At the time, I had no idea of what Neulasta was or what it cost.)
    I must also mention that I have an excellent, company funded, insurance plan and have a slightly above (the median) income, so I don't believe my "selection" was for altruistic reasons.
    I do feel a sense of guilt, knowing that I can receive "special treatment" just because I know someone (who) knows someone (who) knows how to "use the powers to be" to benefit me when others greatly suffer the outrageous costs of medical care.
    Who knows?
    I might just give that form to someone else to sign tomorrow...someone less fortunate because he or she needs more help than I...needs the help of "someone out of the blue!"

  11. My insurance is billed $13,000 for Neulasta of which I have to pay $600. I have a low white blood count for whatever reason. 13 years ago I didn't have to pay a co-pay. Now I pay $50 a month on a "plan". My worst fear came true and I need another injection and still owe $400 on the last one:( The price is about as ridiculous as healthcare is anymore.

  12. Hi Nicole…..Thanks to sharing your experience. Now a day cost of medicine and hospital charge is too high.If we don't take any proper Health Insurance it may create problem in crucial time.

  13. Wow! I too just found out how expensive this shot of Neulasta can be. I couldn't belive it. I had to look it up because I thought it was an error. I could believe 500 dollars but 5 thousand. Well, it seems none of us can afford to be sick of anything nowadays.

  14. Nicole, and everyone else, thank you for your replies. I have leukemia, on Medicare, and looking at neulasta shots. The co-pay is prohibitive for me. I've been disabled since 2008, and have already sold most everything. and now have a bad credit rating. I was in the medical purchasing field for over 30 years, and, ya know, NIH does a lot of this drug research, then the drug companies take NIH research, and tell us that - they have to pay for R and D. We live in a capitalistic society with unbalanced and unfair markets.

  15. I live in upstate New York and one shot of 6mg of Neulasta was $17,288.60! I've had 6 shots. Three regular and three on body injection. I just don't understand why it's so expensive.


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