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Marilyn 07-12-2009 06:20 PM

The cost of Herceptin
 
My Herceptin costs have recently increased from $4800.00 to $12,000.00. I get treatments every 3 weeks and have taken Herceptin since 2001. Does anyone have any idea why the price has increased so much? Has it increased like this for anyone else? I have concerns about reaching my insurance cap.

Sheila 07-13-2009 06:17 AM

Marilyn
This is a question I brought up a few years back....you will find a significant difference in the price people pay for Herceptin....my hospital was one of the highest in the country at that time...with the help of the wonderful women here, I was able to get Herceptin pricing from all over the country. When i showed this to the hospital, and asked them to reduce the price, they refused. I then filed a complaint with the Illinois Attorney General against the hospital....they reduced the price, and back paid patients and insurance companies for 2 years....its worth a try. The price on mine has slowly crept up again...why dont you start a thread...How Much do you pay for herceptin and see what answers you get....i am wondering if the price is so varied? I found a price difference of 8,000.00 per treatment here in Illinois back when I did my research. I feel we should be able to choose where we go by Dr's, not by the price charged for the drugs!

Marilyn 07-13-2009 06:39 AM

Wow, I guess I am in the dark about the costs. I just assumed it was the same price for everyone. I am at the same oncology clinic so I'm not sure. I have a treatment today so I am going to ask some questions. I called the billing office the other day to make sure that there hadn't been a clerical error and the person I talked to told me that the price had gone up and that I was still getting it off cost. I really don't know for sure what that means. Thank you for your input Sheila.

Sheila 07-13-2009 06:49 AM

Marilyn, I am getting herceptin every 2 weeks to coincide with my chemo treatments....(I have gotten it weekly, every 3 weeks etc) I just looked at the cost, and for the drug alone, no infusion and supply charges (which is over 1200.00) the cost of my Herceptin is $7703.50....each time.

suzan w 07-13-2009 11:44 AM

WOW...what price we pay for a miracle drug...I never realized how much the $ can vary depending on where one lives...

alicem 07-13-2009 01:29 PM

Marilyn, 2 things - -
  1. I went to my Insurance Claims page to check on my costs. When I got a single dose the cost was $2385. Now that I am on a triple dose, the cost is $7473.
  2. You kept me from missing my appointment for my MUGA scan this morning!!! The appt. was made by my oncologist's office at least 6 weeks ago and I had forgotten about it. As I was looking over all the claims made by the various entities I was trying to remember what each one was for. I got to the MUGA I had in April, and all of a sudden it dawned on me that I had an appointment for another one coming up. I got my calendar out and saw the appt. was for 10:00 this morning, then I looked at my watch and it was 9:51! YIKES!! I immediately threw on some clothes hopped into the car and tried to avoid any radar guns!! Made it there only 10 minutes late.
If it hadn't been for your post, I would have forgotten about it completely! Thank you, thank you, thank you!!

Alice

donna77 07-13-2009 01:39 PM

That is an interesting question. The charge for my herceptin was $8413 but my insurance company has worked out savings in advance of any treatments so the actual cost is $3454

Chelee 07-13-2009 05:02 PM

It's been 3 yrs since herceptin but if I remember right my insurance was billed $3800 each time. I'll have to dig up the EOB and see if I'm right? (I'm sure I'm close.)

Chelee

Karen Wheel 07-15-2009 07:22 AM

Herceptin costs
 
WOW! I'm really in the dark. I'm American but living in Italy - and I have to say "socialized" health care is the way to go.
I have paid nothing for all my surgery, care and treatments (chemo, Herceptin, and now doing radiation) --- and now I realize just how lucky I am! WOW! At 7K per treatment - I've already had 5 --- thats 35K! It seems very amazing to me how much MONEY there is in cancer ... no wonder they haven't found a real CURE! Unbelieveable - and so flipping sad all in one breath --- why would these drug companies want to really find a cure - when they can take this much money from the system (or our pockets) to try to fight it. This is a very interesting topic (I think)!

Okay, I got side tracked there with my rant! :-)

One more question I have is that my doctors here have said I should take Herceptin for a year --- once every 21 days - and I think I understand from starting reading here on the site in the US - they give this treatment longer than a year??? What are your doctors telling you in the US?
Thanks! Karen

alicem 07-15-2009 09:42 AM

Karen, first of all, welcome to the forum, I am glad that you found us. I think that you will find an amazing amount of knowledge and support here. Cancer is the enemy at this website and we all detest it.


That being said, I agree that our health care system is not perfect, but I do not agree that socialized medicine is the way to go. I have heard many horror stories from across the pond as well.

When I talked about the cost of my triple dose of herceptin . . . that is the claim amount that was filed by my oncologist with my insurance company. That number is $7473, but the insurance company has an "agreed pricing" figure with TX Oncology of $2881. The cost to me . . . $0. That is because I have already reached my out of pocket costs for the year of less than $4,000. So yes, I paid $4000 (not $35K) more than you did for my entire treatment. However, from what I understand, your taxes in Italy are so much more than mine are. I know because I lived in Milano, Italy with our family for 2 years in the early 90's. We had to pay both U.S. and Italian taxes. I was taught in business school that there is no such thing as a "free lunch". I have always found that to be true.

The standard for newly diagnosed, non-stage 4 cancer is one year of Herceptin. I think you might be seeing some women have received it for more than a year and I think that is because they have advanced BC, or it has metastisized. I myself will be getting it once every 3 weeks for a year, just like your oncologist has recommended.

As far as your comments about whether or not the drug companies have any incentive to find a cure? Do they have ulterior, greedy motives? I'll admit that has crossed my mind. But my belief in the goodness of humanity overcomes those doubts. I cannot bring myself to be so cynical. I think thoughts like that do an inservice to all the dedicated scientists that are out there day after day, spending many long hours in the lab looking for answers. My sister-in-law had breast cancer 10 years ago. Her ordeal with chemo and radiation inspired her daughter Kimberly, my niece, to get her PhD in Chemistry. She just graduated from Cal/Berkely where she spent 5 years doing synthesis of a potential cancer cure molecule found in rare tree bark, or something like that. (My chemo brain won't let me remember exactly what :) ). She literally spent months on one reaction where she got less than 4-5 hours of sleep a night. The reaction never worked and she had to go back to square one. Finally after 5 years, she was successful. All this just to synthesize one molecule, and she is not even sure if it will be successful when it comes to treating cancer.

Whenever I start having my doubts, I look back on how far we have come in the last 30-40 years. The treatment for Breast cancer even 40 years ago is liken to the middle ages when you compare it to the treatment and the drugs that are available now. Even though great strides are being made, this is a slow process. Even Dr. Slamon and Genentech, the scientist and drug company responsible for Herceptin, admit that it was like finding a needle in a haystack. You might be interested in the book "Her2: The Making of Herceptin" by Robert Bazell or the movie based on the book, "Living Proof" - - it was just released on DVD and is a fantastic movie!!! It does show that there are definitely politics involved as well as being concerned with the bottom line when it comes to making decisions about clinical trials and finding new drugs.

I don't know what the answer is. If you take away what appears to be a huge profit, you also take away incentive - that is just human nature. The drug companies are beholden to their stockholders (which in reality is anyone with a pension plan, a 401K plan, a mutual fund, etc., i.e. . . . most of the American public) to make a profit. Another thought, for all the success and HUGE PROFITS that come with a drug like Herceptin, there are many, many, many potential drugs that look promising at the beginning only to fail at the end. The drug companies have to eat those costs. With risk comes reward, but also potential failure. I believe that there will be a profit in drugs that will cure us. Finally, with the statistics of 1 in 8 women getting breast cancer, the odds are very high that each and every scientist & drug company executive is touched personally by a loved one - mother, wife, sister, aunt, a friend, or an acquaintance who has been diagnosed with breast cancer. How can they NOT want to find a cure? This doesn't even take into account the FAME factor that comes to that scientist(s) who discover a cure.

Well, Karen, I am sorry that I rambled on so long but you touched a nerve. This might just be something that we will have to agree to disagree on. I am definitely open to differing opinions from others and would love to hear from you. Please know that everything I have said, was my opinion, and I do respect your right to your opinion. The last thing I want to do is scare you away from this website because it is so wonderful.

Buona notte! Ciao!

Karen Wheel 07-15-2009 10:04 AM

Thank you - response
 
Thanks for the note back - I understand your postion, however I still doubt that drugs are the ultimate answer. I am doing the conventional therapy but also changing drastically my diet and what I am putting in my body - so I can hopefully stop the cancer in its tracks so it won't come back. My issue with drug companies is the pricing (yes, they have great risk) but also that only a "drug" can be called a cure... if there was money in vegetables we would all have all kinds of clinical studies and proof that changing the PH in our bodies (by mostly eating veg and not eating animal products or processed foods) is enough to save us from EVER getting cancer .... and can actually reverse the effects of cancer and disolve tumors. Our bodies are that amazing that they can vitually heal themselves.

That was my rant - that there is too much money in the cure .... in general - and I find where there is money, yes, there is motivation, however ... there is also the "power" card and with power there is cruption. Plain and simple.

In regards to overall - I have my opinions, and I wholeheartedly respect yours - and I know that many of us are searching for a road that will save, or prolong our lives. So, no offense taken on my behalf.

As for living in Italy, the health care system here, I am sure is flawed, but my experience has been unbelievably good. And - the no-cost thing is amazing. I do not work here so I am again, lucky. However my fiance does and he pays a lot in taxes, but .... they have a lot of benefits here (not just health care), so everyone is paying for them and everyone is eligable to have health care --- even at 4-8K a treatment for Herceptin. I ... in turn, Thank God for that.

Take care and good luck in the fight!
:-) K

alicem 07-15-2009 10:45 AM

Now there is something that we can agree on! I definitely think that there is a connection between diet and cancer. I don't necessarily think that diet necessarily "causes" cancer, otherwise every obese person in america would be getting it. It more than likely exacerbates it though. If you are genetically predisposed towards cancer then your diet/exercise plan might just push you over the edge. As for me, I am suspicious of all the years I spent in the chemistry lab in the late 70's. I was a chemistry major myself, spent a year doing research. I shudder at the memories of spilling benzene or carbon tetrachloride on my skin and doing nothing about it because it just evaporated! I was more careful when it came to hydrochloric acid or sulphuric acid. UGH!!!!!!!!!!

I too have changed my eating habits. Six years ago I changed my exercise habits and I think that might have saved my life. I couldn't even run 100 yards without getting out of breath. Two years ago, I completed my first marathon. (The human body is amazing). I didn't run the whole way, but that is my next goal! I also absolutely love triathlons! Have done the Danskin 4 times, along with others. My youngest daughter did it for me this year since I was unable to due to my chemo.

I did have a good experience with the Italian healthcare system. In 1993, one of my daughters had an ear infection. The English speaking doctor where we lived made HOUSE CALLS!!! Imagine that. He was in and out in about 10 minutes. The charge to us was comparable to what we paid in the states. On another occasion, my husband went on a business trip to Grenoble, France towards the end of school. When the girls were finished with school for the year, we drove over to meet him from Milano. Half way there (a 4 1/2 hour drive), my 8 year old started complaining that she didn't feel well. I felt her forehead and she was burning up. Fortunately when we got there, there was an American family living there in a quaint little village just outside of Grenoble. I took her there that afternoon and the wife arranged for her doctor to see us, no need to wait. We walked down cobblestone streets to his building. (my daughter still remembers this!) He diagnosed her with strep throat. The only thing we had to pay for was the antibiotics. The office visit was free. I did feel fortunate because it was my husband's company that was paying our Italian taxes, so in a way, we didn't have to pay a thing either.

I envy you being in Italy. It is a fabulous country. Would go back there in a heartbeat!

Alice

michka 07-16-2009 03:06 AM

I was so surprised by the prices you posted that I went to look into my files: Herceptine (my every 3 week infusion) was billed 1897€ (around $2500-2600) to the French Social Securiy in 2007. I payed 0.
Michka

Karen Wheel 07-17-2009 07:51 AM

Italian healthcare
 
yes, ....love the house calls! My family doctor is great - she came to see me at home (and brought me a flowering plant) the day I came home from tumor surgery and always makes time for me when I need to just stop by and ask her a question (and all at no cost!)
So, for those of you that are thinking that "socialized" medicine doesn't work, well, I am a HUGE fan (before when I lived in the US ... no!) but now, trying the system and even in a "different language" well, I'm really impressed. Thank god I'm not having to pay those high insurance fees, deductables, drugs that aren't covered ... etc. .... I just am really thankful.

And, hey, its beautiful here too! :-) Always helps the mental attitude! Sun, sand... sea!

Karen Wheel 07-17-2009 07:54 AM

Diet and PH
 
For those of you wondering about diet -

Two great books I have read (and am applying now) are:

Crazy Sexy Cancer Survivor - by Kris Carr
Wonderful read - and the first cancer type book I read - but Kris is awesome and started me on my quest for "eating to live"

And...
The Cancer Battle Plan - by Anne and David Frahm
(this book is an easy read and lays out an agressive "how-to" plan .... very cool!)

vlcarr 07-20-2009 09:16 PM

I just started my herceptin treatment at Vanderbilt University in Nashville. My first treatment was $6,298 (they said I got more the first time). The 2nd treatment was $4,618 and these are the costs for the drug only. The total bill for the first and second treatment was $12,757.30!!! This hospital is a preferred provider with my insurance so I'll be curious to see how much they approve and pay. Since I've met my out of pocket for this year there will be no cost to me. I must admit I was shocked at the cost.

harrie 07-21-2009 12:30 AM

in 2007, the cost of the drug only was less then $2,000. I think it was around $1,600 or so. (per tx for herceptin) Ins covered it all. I didn't pay anything out of pocket.

juanita 07-21-2009 08:25 AM

the cost of chemo varies too. if i had done tac with my second onc instead of the cmf, it was still cheaper for the tac with him than it was my first onc.

jhandley 07-22-2009 01:43 AM

cat among the pigeons
 
Hi everyone
Herceptin has a half life of 28.2 days so you could try having it every 4 weeks rather than every 3. You can have up to 6 weeks between treatments before they need to reload you. The 3 week dosing protocol allows for people to get over any other minor illness say a flu or bug and still not need reloading.
I am currently suffering from what is probably swine flu and should have had a treatment this week. But I will be better by next week hopefully and will have it then.....5 weeks from my last treatment.
I have been having it 4-5 weeks for years and am still NED (Stage iv). In Oct I will have been on herceptin 4 years.
So if the cost is a major factor, timing is something to think about.
jackie (down under)

Adriana Mangus 07-22-2009 04:26 AM

Hi from Adriana
 
Hi Alice:

Don't know anything about the cost of herceptin, only that it's priceless to me, as it has kept me alive all these years.

Can't tell who the mother is. Nice pic.


Love,

Adriana


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