Centecor raised the price of remicade

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petittarte
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Date Joined Apr 2006
Total Posts : 686
   Posted 10/8/2008 5:21 PM (GMT -7)   
but the insurance companies aren't paying the doctors more so now my doctors office may stop giving the infusions because they are losing to much money. They break even on the drug itself but lose money on the cost of the infusion room and the nurse who administers it. I love my remicade nurse. I bring movies and popcorn and we have a great time. I would hate to have to go to an infusion center.
Jodi

Remicade and 6MP


CrohnieToo
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Date Joined May 2003
Total Posts : 9448
   Posted 10/8/2008 5:24 PM (GMT -7)   
What? The greedy buzzards at Centocor aren't already making ENOUGH money on Remicade? Sheesh!
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.


patientspiders
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Date Joined Jul 2005
Total Posts : 733
   Posted 10/8/2008 6:46 PM (GMT -7)   
Before I stopped the Remicade earlier this year I heard the same thing... it's a shame. My GI's office had a nice infusion room, but now it's just sitting there empty and everyone has to drive to an alternate office (that is really far away which is great when you're doped up on benadryl) or go to the hospital to get it. I would be REALLY interested to know how much each vial of Remicade ACTUALLY costs to MAKE. I bet with research, trials, freebies, advertising - with every cost to Centacor calculated - I bet that each vial of Remicade still only costs about $200 bottle. That's me being generous too. I wouldn't be surprised to find out that each vial really only costs $0.50

Bah. Greedy buzzards is right.
26f, dx'd CD July '05 after 6 fistula/abscess surgeries
Currently running on Humira and Hope.
(miscarried at 13 weeks, now waiting to heal before trying again)

"Our greatest fear is not that we are inadequate, but that we are powerful beyond measure."

~Marianne Williamson


FitzyK23
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Date Joined May 2005
Total Posts : 4219
   Posted 10/8/2008 7:12 PM (GMT -7)   
Find out what the difference is and if it is worth paying out of pocket for. I just found out that my dentist is not a preferred provider on my husbands insurance (I had my own plan before), but the difference between getting a new dentist and staying with the one I like was only $8!!! I am sure yours would be a lot more but it might be worth asking. Sometimes you just can't put a price on comfort. And if your doc knew you were that loyal they might discount the difference for you.
27 Year old married female law student (last year!!). Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night. I also take a birth control pill to allow some fun in my life.


petittarte
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Date Joined Apr 2006
Total Posts : 686
   Posted 10/9/2008 2:58 PM (GMT -7)   
Each vial costs the doctor $570.  With what the insurance company pays that leaves about $60 to pay the nurse and for the use of the room.
Jodi

Remicade and 6MP


Ides
Forum Moderator


Date Joined Nov 2003
Total Posts : 7077
   Posted 10/9/2008 3:59 PM (GMT -7)   
When Remicade was the only biologic approved for Crohn's, and it was showing great promise in gving patients relief and possible remission, some GIs decided to open their own infusion centers. Insurance companies reimbursed the practice for the medication cost less the patient's co-pay if any. Depending on the insurance plan, doctors agree by contract to accept specified reimbursement for the "delivery" of the medication. This usually includes the IV solution, personnel to oversee the patient for a set time limit, etc. The set reimbursement varies widely between insurance plans. Where my GI lost about $100 on each of my infusions, his contract with another insurer might be more generous and net him enough to cover that deficit plus a little extra.

What is happening now is a couple of things. Remicade iis no longer the only biologic. Fewer patients are using Remicade. Private GI infusion centers are not as well utilized so the salaries of the personnel might not be covered by the fewer insurance reimbursements. Doctors will only continue to absorb such a loss for a short ime. In addition, the cost of biologics increases approximately 7-8% a year. Depending when the insurance contract was executed, the doctors might not recoup even the cost of the medication.

Just my $0.02.
Moderator Crohn's Disease Forum
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, and a host of other medical problems.
 


ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 10/9/2008 4:04 PM (GMT -7)   
Why does the price of biologics increase every year, Ides? That seems almost counterintuitive.

Interested,

I.
Co-Moderator Crohn's Forum.


patientspiders
Veteran Member


Date Joined Jul 2005
Total Posts : 733
   Posted 10/9/2008 7:06 PM (GMT -7)   
Very informative Ides. I'm very interested in the same question Ivy asked. Why do biologics go up?
26f, dx'd CD July '05 after 6 fistula/abscess surgeries
Currently running on Humira and Hope.
(miscarried at 13 weeks, now waiting to heal before trying again)

"Our greatest fear is not that we are inadequate, but that we are powerful beyond measure."

~Marianne Williamson


CrohnieToo
Veteran Member


Date Joined May 2003
Total Posts : 9448
   Posted 10/10/2008 5:11 AM (GMT -7)   
The same or similar reason as to why groceries, clothing, most anything we need or buy goes up when the price of oil per barrel goes up? And when there is a valid excuse to raise prices I'm sure very few resist the temptation to tack on just a shade more profit to the "justified" raise in price.
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.


tsitodawg
Veteran Member


Date Joined Sep 2006
Total Posts : 845
   Posted 10/10/2008 1:08 PM (GMT -7)   
I was on Remicade for 3 1/2 years at 10/kg every 4 weeks. It blew me away every time that I received my bill that my insurance company was billed. Some months it was $10,000 and other months it would go as high as $18,000, even though my dose never changed. I did notice that the price went up as soon as Humira began to be used. My Brother-in-law works for Abbott and it is amazing how much money they have made since they purchased the company that created Humira. We were just talking about this last night because I was approved to start Cimzia and had never heard of the company that CIMplicity. He said that most of these medications are created by smaller companies and then sold to the bigger drug companies when they become approved by the FDA. In my own opinion, I think that the reason that Remicade is going getting more expensive is because it is becoming more widely used for other disease and conditions besides M.S. and Crohn's disease. I am sure that it will not take long for Humira and Cimzia to follow this trend. It is all supply and demand, and of course the fact that when someone becomes dependent on a medication, they can raise the price.
One of the neat things with Cimzia is the fact that they will pay for the first 3 infusions for anyone that is approved to try it. I also just got a card in the mail today that gives me a discount on my copayments for the first 6 months and could possibly be extended for up to a year. For those receiving Remicade, I have found that that it was actually cheaper for me to receive my infusion in the infusion therapy center at my local hospital, rather than going to my doctor's office. When I did it at my infusion therapy center, I only had to pay for the copayment of the center($25 through my insurance) and did not have to pay a dime for the actual medication or premeds. This probably all depends on your insurance, but I would look into it and see. As for the cimzia, they are making me receive it through the homecare network because I am one of the first to get it in my whole state.(possibly the first according to the Pharmacist that is helping me)
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