Unregistered

I am a university student and have been doing my best to help a neurologically-challenged patient under treatment for her2neu positive breast cancer patient file her insurance papers.

I became aware of your site as a source of information regarding what insurance companies are paying for herceptin when I was told of a previous "roll-call" (which I found in your archives) regarding Herceptin pricing.

The lady I am trying to help has been under treatment with herceptin for over six months and her bills are mounting.

I was totally dismayed to discover the absolute refusal on the part of her insurance to pay even the "wholesale" price of herceptin,stating that the "usual and customary price" of the triple dose of herceptin she receives every three weeks is less than a third of the price she is charged (which is half the price of the nearest large hospital cancer center). This leaves her to pay over $6700 for every 3 week infusion.

After unsuccessful attempts to gleen information from representatives at Genentech, as well as the billing office of her oncologist and the billing office of a the nearest cancer center, I suggested the repeat roll call on your site.

It appears Herceptin pricing is secretive.

I was not trying to sound secretive, nor like a "plant" from some insurance company or oncologist's office. It seems noone is being straight-forward, perhaps for the reasons I hypothesized in my post. Everyone seems to have their own agenda.

With 39 persons reading the post, and yours as the only response, I do not hold out much hope that the her2group will repeat the roll call they participated in earlier this year which helped a member fight the inflated charges demanded by her treating hospital.

I know that the lady I am assisting would have greatly appreciated if not an outpouring of information, at least some sort of response besides suspicion of my motive! Not only does she have the disease to fight, but her insurance company as well. A little information would have been a great Christmas gift for me to give to her.

How will patients ever be able to bring some transparency to what hospitals and providers are charging, and insurance companies reimbursing, if they do not feel free to share information on what they are being charged and what their insurance companies are paying for Herceptin? I was so impressed by the outpouring of support on this website during the previous roll call regarding Herceptin pricing and your response(Lolly) and lack of response (38 others) has amazed me.

The suspicion now shown reminds me of tenants of an apartment complex who will not discuss their rent increases with one another for fear that, if it gets out, they will receive a greater increase. Sharing information on the pricing of Herceptin cannot help but enable patients to get a better price or get the chance to go somewhere else where the price is more affordable!

No, I am not one of the insiders on this website and perhaps you are right that if I am not a regular contributor of information or advice perhaps I am not entitled to ask for an outpouring of such "sensitive" information (perhaps it is the body weight request which kept people from coming forward!)

I remain confounded as to how much one is being charged and how much one's insurance is paying is considered so " intimate" and "sensitive" information. There was no request to identify oneself by name, merely to list treatment facility and location, insurance company, amount charged and amount reimbursed, whether weekly or every 3 weeks and estimated body weight.

Members and nonmembers of this site freely shared this information during the previous roll-call /request for information on Herceptin pricing. Was it because it came from someone they were well acquainted with from previous postings? Is that a rule of calling for a "roll-call"? Does providing my name and city really make the difference? Perhaps you can enlighten me.

Laura Adams
Charleston, South Carolina