I need your help on cost of Herceptin ASAP

Many of you may remember that the hospital I am currently receiving herceptin at has doubled the price...to the tune of $11,887.00 for the Herceptin alone every 3 weeks. Then add the administration fee of 682.00 and the IV fluid at 100.00 makes each treatment around 13,000.00. I am trying to make my point with the hospital that they are overcharging severely...and in my eyes, taking advantage of women with breast cancer who depend on this drug to survive. I can receive it cheaper elsewhere, but why should I have to change oncologists, just because the hospital wants to make money on those of us who need this drug....I really feel that having BC is enough stress without this added worry. I have spoken with several people at Genentech and they have assured me that the Herceptin has not had a price increase. I have spoken with the AMA, the Komen Foundation, the ACS and the Herceptin sales rep for Genetech here in IL. The people at Genentech said I need to contact someone who can check this out.....so I have called a Chicago News Station, and they are willing to do an investigation into this if I can show them that people in other areas and states pay half or at least much less than what I am being charged. SO I NEED EVERYONE WHO IS ON HERCEPTIN to help me make my point...please reply and state the amount you are charged per infusion for the Herceptin and whether you receive it weekly or every 3 weeks and also what state and city you get it in. I need all the ammunition I can get to fight this....for myself and any other woman who is receiving Herceptin at Rush in Chicago. Even my Dr and the chemo nurses are trying to help, but the bureaucrats at the hospital won't budge....maybe the news will get their attention. I need your replies ASAP as they will start to look into this next week.
Thank You
Hugs
Sheila

[Lolly]

Sheila, my most current statement from my clinic shows my WEEKLY Herceptin being billed at $2,208 (for 160mg or 16 units), I.V. administration at $354, and other misc. associated costs at $96, for a total billed charge of $2,658.
When I was on the 3 weekly maintenance dose I was receiving 480mg (three times my weekly maintenance dose), so that would translate into a charge of $6,624 for the Herceptin, then adding in the other infusion costs brings it to $7,074. BTW, $87 of the amount was for blood draw and lab work, and that isn't an expense for every visit.
I'd prefer to e-mail you privately with my city and state, e-mail me and I'll supply that info, and I'd be happy to send you a copy of my last statement if it would help; let me know if you need this.

<3,
Lolly

Shelia, I live in Norridgewock, Maine and get weekly Herceptin and it cost me $1400.00 that is only $5600.00 a month. I don't blame you doing what you are doing. That is highway robbery. I don't understand why your insurance is allowing them to do this. They are are just as much to blame as the hospital because if the hospital weren't getting paid they would do something different. I wish you luck. You don't need this stress. Hugs, Sandy

Shelia,

Encinitas California, San Diego County. $5850.00 for triple dose every three weeks.
Add $641 for medical and blood work for a total of $6,491.00 Insurance company reimburses $2,813.22.. I pay $22.59 out of pocket.

I can also send a copy of my statement.

Hugs,
Christine

Hi Sheila:

This is highway robbery. I don't take herceptin, but I wish to voice support for your fight.

I would encourage everyone to EMAIL or FAX invoices to Sheila. The news outlets will be looking for hard evidence that they can corroborate to advance the case. The more the better!

You rock Sheila!

Merridith

[Lolly]

Sheila, I want to add to my post below: I just received my insurance statement for March, and of the BILLED charge, $2,562.00 for Herceptin and infusion, my insurance company actually PAYS $1,105.58.
Again, happy to provide you with mailed or faxed copies of clinic statement and insurance statement, if you wish.

<3,
Lolly

I am treated in East Setauket, New York (Long Island). I get weekly Herceptin. They charge $2,014.00. Medicare approves $1,006.81 of that. A three week dose is charges at $6,162.00 and Medicare pays $2,028.29 of that. If you would like a copy of my statement, just e-mail me. I am always willing to take on the system. Several years back, the makers of Taxol overcharged cancer patients. They mislead everyone so that they could put off competition from generics. Considering that the research for Taxol was funded by our tax dollars, BM had no right to do what they did. There was a huge settlement, and I got back over $500.00 (even though my insurance paid most of the charges) at a time when I really needed it. Don't ignore those Class Action Lawsuit notices in TV Guide, Readers Digest and all the other magazines. You never know. Good luck on your fight.

Live in Atlanta. Cost of Herceptin is 2888 every three weeks.

Good luck.

I get billed $1776 weekly for the drug only. I am in Northern NY
Good luck
Kathy

Sheila,

I don't have my Herceptin amount now, but I'll get it.

Last year, I heard from my doc that insurance companies, following Medicare's lead, were going to reduce payments for certain chemo drugs this year.
I wonder if Herceptin is one of them?

Not saying that it's right, but it's possible that the hospital is reacting to reduced insurance payments and is raising their costs accordingly. Have you asked about this?

Go get 'em!

Love and light,

Lisa

Here in the Netherlands, Europe 150mg Herceptin cost Euro 750,- (incl. 6% VAT)
Which is around US$ 580,- (Cost of Herceptin only, not the administration)

Sorry, exchange calculation error:
Euro 750,- should be US$ 975,-

[anne]

Hi,
My mom's on a trial for Herceptin, so it is free, but our onc said that it is $6000.00 per week even without insurance coverage. I am in D.C. and $13000 sounds crazy per infusion even for this area. You are right to let them have it. This is disgusting when people need this drug to survive. Way to go!!!!

I can't believe the difference in costs. It is totally a crime.

I have three different Medicare discount cards because they give different discounts on different drugs. My pharmacist runs each card and I take the lowest price. Femara can cost me $246.00, $89.00 or $12.00. Go figure.

Anyway, if I had the energy, I would take on the system. That was the way I wanted to go before the relapse. I earned my Associates in paralegal studies and was on my way toward law school. Right now I can't remember what I ate for dinner, maybe I'll go back when my brain cells recoup.

[StephN]

Hi Sheila -
Great that they want to do an expose of this pickpocketing cancer center.
I answered to your first post a few weeks ago as to the cost of my every-3-week infusion of Herceptin. You could pull the figure from there.
This is at a major center in Seattle.
Price has not changed in 3 years for me. I think I posted both the billed and insurance allowed amounts. I pay nothing once my $750 deductible and stop loss are met. That does not take very long at this rate!

Get 'em, Tiger!

Spokane, WA
every 3 weeks:For Herceptin only: $6298.00


additional: IV Inf Addl Hr Chemo:$165
Chemo IVPB 1 hour $652
Normal Saline $ 23


Lola

Hi Sheila,

My insurance gets billed about $4100 for my herceptin every 3 weeks. They deduct a 10% provider adjustment and pay the balance of $3690. I did not include the charges for the doctor visit and bloodwork, just the cost of the herceptin and related infusion room charges.

My big concern has always been what to do if I do live long enough that my insurance runs out. I have racked up such huge expenses since I started this odyssey back in 97, that I really do worry about that! I would hate to have to loose our home and all our hard earned assets, before we could qualify for any type of assistance.

What really gets me is that they advertise on the radio, that a person can get a full body PETSCAN for peace of mind and it only costs about $1000, but when I go in for a scan, my insurance gets billed around $5000!

I know I shouldn't complain, cause I'm grateful to still be here, but it just isn't right.

Kim

That reminds me that again it has been said that cancer is a multbillion dollar business for the Health Care System. This is only one example. I almost had a heart attack when I saw a man come in for a procrit shot and he said it cost him $9000.00 a week a total of $36,000.00 month!!!! Tell me what is wrong with this system. Its all about money. We are at their mercy. To me that is highway robbery. Go get them Sheila and by the way Good luck. hugs, Sandy

Sheila:

I live in Arizona and receive Herceptin every three weeks. My oncologist charges $4422 fpr the Herceptin and $652 for the administration of the IV. The insurance reimburses $2264 and I pay $25 and the rest is written off as an insurance contract adjustment. Good luck in your effort to get a fair price. By law hospitals can discount Herceptin to you just as they do insurance companies. At one time hospitals could not charge anyone less then they charged Medicare and Medicaid patients but that has been changed.

Barbara

My weekly cost is billed at $1275 for herceptin, $220 for administration and $40 office call. Of that...BCBS pays $906 for hercepin, $65 for supervision, and $21 for the OC. I am in Indianapolis. I wish you luck with this. It seems there is something very wrong here! Judy