The ridiculous cost of Lupron in the US - Advanced Prostate...

Advanced Prostate Cancer

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The ridiculous cost of Lupron in the US

Tall_Allen profile image
67 Replies

I don't know why the article doesn't mention Eligard.

npr.org/sections/health-sho...

67 Replies
BobbyMac07 profile image
BobbyMac07

Sky high cost is terrible!

cesces profile image
cesces

It's purpose isn't to communicate treatment information so much as to make the point of out of control medical costs.

SPEEDYX profile image
SPEEDYX

My last injection was $6300 at MSK...there even was a shortage last year ...I have Medicare I dont know if that factors in..Thanks

Rodeoz15 profile image
Rodeoz15 in reply to SPEEDYX

WoW. My last generic leuprolide injection costed me $170 in India. Can't imagine $6300. Just a disclaimer: We don't have insurance cover for medicines here.

Tommyj2 profile image
Tommyj2 in reply to Rodeoz15

if you are on Medicare ,part b should be covering the injection. Patient responsible for residual 20%

mperloe profile image
mperloe

I used to prescribe monthly Lupron for women with endometriosis. At that point a one mo the dose was ~$600. A 2 month dose for men with PCa was $182. As a physician administered medication United Healthcare required me to provide the drug. Iwould have to pay $600 for Lupron and got reimbursed $400.

This pricing is ridiculous. It would be good to get Zero to pressure the govt to negotiate better pricing.

Tall_Allen profile image
Tall_Allen in reply to mperloe

In a way, sky-high costs of new drugs are more understandable (i.e., recoup R&D expenses). This hiking up the prices of old drugs like Lupron is just price-gouging, with complicity from hospitals jumping on the band wagon.

TommyCarz22 profile image
TommyCarz22 in reply to Tall_Allen

It's the drug of choice for the "Transition" enabling Dr.'s and pharmaceutical companies. Originally meant to help men with Cancer, but in this crazy age of what you see isn't always what you get (ie: the "Pronoun Period" of entitlement) it's become fashionable to use as a hormone blocker to help Kids "Cope" with life's daily disappointments. Using these Cancer drugs for "Off Label" applications, drives up demand. And driving up demand of anything, in such tumultuous "supply chain" crises , will ultimately drive up costs. The world is in a sad state right now. I pray we find our way out of these dark times.

swwags profile image
swwags in reply to Tall_Allen

I did read an article some time ago about a short seller who sues Pharma companies for finding new purposes for their drugs and getting their patents renewed. He has some success but to me, the US Patent Office is one of the biggest offenders.

"We'd like to reapply for an extension on our cancer treatment injection please>" "Oh, what else does it do?' "Its a very effective floor wax".

Teacherdude72 profile image
Teacherdude72 in reply to Tall_Allen

But if the R&D expenses were tax deductible from day one high cost wold be less.

compiler profile image
compiler

It all depends on your plan, to a ridiculous degree. I've been on Lupron 4 times (one time 3 months; the others 9-15 months). My cost was not bad at all. As I vaguely recall, it was under $100. The article refers to Orgovyx as so much better AND CHEAPER. I suspect "better" is accurate. I am heading towards Orgo. unless my PSA has a pleasant surprise for me in December. MY COST will be 40% of their retail price. My cost will be $981.84 per MONTH. I am investigating alternatives, including aid from Orgovyx.

Mel

Sherpa111 profile image
Sherpa111

I take Eligard (sp?) which my insurance company thankfully pays for in full. I hate thanking any insurance company, however, it is $1,800.00 for a six-month shot. I was floored when I saw the invoice.

leebeth profile image
leebeth

I agree that price gouging by systems is unconscionable. But I am equally embarrassed by the small pittance that Medicare approves for some of these things, and I can see how challenging it can be for the systems to stay afloat. The tiny amount approved for an office visit! When I think of the time and all the extras that my MO does for us, I wish I could pay him more.

Yes, charging this much for an old drug is wrong. Our system needs an overhaul.

I do support strongly that we have research and development so new drugs can profitably be brought to market. This is not the manufacturer gouging; it’s the hospital system.

Blame is not always placed appropriately.

roncyn profile image
roncyn

I use Zoladex a lot cheaper in the 700’s to 800’s..

ExPat193 profile image
ExPat193 in reply to roncyn

I had one three month injection of Lupron in states before seeking alternatives in Netherlands.

Big difference in care, attitude and cost. 8000 euros total cost. Radiation, seven as opposed to forty-three proposed radiation treatments in states, medication and follow up care.

Placed on six, three month implants of Zoladex.

Zoladex 10.8 mg cost in states $2300, same med here 216 euro Medical care in states rip off I know, I’m retired nurse who set the prices for major city hospital

Kaliber profile image
Kaliber

I have the government OPM insurance provider … I get it through Kaiser. My 3 month Lupron shot ( just had one Tuesday ) cost me nothing with Kaiser. My $12,000 a month Xtandi costs me $100 co-pay monthly tho. Guess I’m lucky .

Tall_Allen profile image
Tall_Allen in reply to Kaliber

The price is what the manufacturer charges. Patients always just pay co-pays on covered drugs.

Kaliber profile image
Kaliber in reply to Tall_Allen

Roger that. I think that a pharmacist once told me that Kaiser paid about $1500 per 3 month kit. Might be just what they put on their billing tho.

rick8637 profile image
rick8637

cudos. TA. You are a true advocate and my thanks ..

chickgreen profile image
chickgreen

I read this article earlier today - I find it strange that these two shots cost over $35k each. Certainly there are alternatives, and even before insurance the number I find on my explanation of benefits is about $7k, which I think is still too high.

Tall_Allen profile image
Tall_Allen

"Nuff said?" That says nothing to me.

Happle58 profile image
Happle58

My husband's Erleada is $14K per month. He will probably never get a vacation from it. Thankfully, he kept his insurance for me/us until I turn 65. We pay $50 a month for this medication.

JTrack profile image
JTrack

What about Firmagon instead of Lupron? I heard it significantly less expensive and better.

smurtaw profile image
smurtaw in reply to JTrack

I used 0.3-0.4 mg/day Climara estrogen weekly patches. My cost was about $80 a month through goodrx. My MO added Zytiga. After Zytiga assistance and my commercial insurance copay the cost was $10 a month.

My ADT worked better for me than subsequent Lupron therapy and was only $90 a month.

For most men, Firmagon is better than Lupron.

farmanerd profile image
farmanerd in reply to JTrack

The Explanation Of Benefits from my medical insurance (UHC) shows that my every 4 week Firmagon injection costs $452 -- the amount allowed. Having satisfied my deductible early this year, I only pay the 20% coinsurance amount ($90.40).

EOB shows Firmagon costs $452
cesces profile image
cesces

hmmmn

No one is really mentioning the elephant in the room.

There is one set of politicians whose policy is to support the Pharma business's right to maintain and exploit an imperfect market in pharmaceuticals.

They are basically supporters of corporate welfare.

There is another set who as a group attempt to impose more competitive forces on the pharmaceutical industry.

Statistically, about 2/3 of us cranky old men vote for the corporate welfare pols.

Other countries don't suffer from this problem. Pharma is kept under control.

In the US the corporate welfare politicians have stuffed the Supreme Court with judges who enable the Pharma companies to legally bribe the politicians to provide them with continued protection.

The current administration has enacted a limited ability for Medicare to negotiate Pharma pricing. And even this was a squeeker.

Depending on how we vote in the next few weeks, the bad pols may gain the leverage to undo even this small advance before it takes effect.

This problem is a US problem. The solution is in our hands.

"We have met the enemy and he is us"

Am I the only one who thinks that those of us who are the cause of the problem, really have no honorable basis to complain of the natural and predictable results of their own actions?

smurtaw profile image
smurtaw in reply to cesces

Walt Kelly was correct in more ways than one.

I could be wrong, but I don't think that TA falls into the 2/3rds grumpster camp.

cesces profile image
cesces in reply to smurtaw

Lol

My observation was not directed at Tall_Allen

I hope he doesn't take it that way.

noahware profile image
noahware in reply to cesces

The true "elephant in the room" is a third-party-payer system where costs and prices of medical goods and services have no relationship to any market-based supply and demand paradigm where true price mechanisms are allowed to function.

The hybrid socialized/privatized system we have evolved into is FAR worse with respect to costs than either "extreme" of a purely private or purely socialized system, because those two systems both have incentives at some level to control costs. No such incentives exist in our system, because higher costs are merely shifted to other payers or put off into the future by an uncontrolled growth of private/public debt.

cesces profile image
cesces in reply to noahware

Yes.

I used to work in the industry.

It seems it's the one area that doesn't respond normally to supply and demand.

If you increase the supply of Docs, community health care costs increase and average quality goes down.

And what other market would support the existence of PBMs?

And now private equity is coming in to rape and plunder.

cesces profile image
cesces in reply to noahware

By the way

Its too long of a story, but the third party payor system arose during WWII as the result of government action.

And no healthcare system can be well managed with supply and demand.

For that to work you need a functioning market and informed buyers.

Almost all healthcare money is spent in big ticket procedures and conditions that represent the antithesis of well informed rational buyers.

noahware profile image
noahware in reply to cesces

Yes, I was aware of those WWII origins. It's very interesting.

The problem with a purely market-based system for medical services has always been, won't the best (or even ANY) care only be available to the very wealthiest? And won't a pure market mean private insurers will ALWAYS drop higher-risk and higher-cost patients, since the market says they can (and even SHOULD)?

But to try addressing those issues without addressing perverse incentives, costs, corruption, greed, unintended consequences, etc. means you might end up... well, where we are!

cesces profile image
cesces in reply to noahware

The old BC/BS system wasn't so bad.

They would have something like 70% market share in a community. That enabled them to spread risk.

ronronHU profile image
ronronHU

I can't even conceive of these insane drug and administering prices when my tE2 gel costs me less than $30/month, no doctor visits, and has no side effects other than the initial tiny boobs?

anony2020 profile image
anony2020

You need a second mortgage if you dont have insurance. UK seems not far behind if you go private?

Southjersey318 profile image
Southjersey318

240 MG daily of Erleada 30 day supply monthly is $13800. under my Medicare Insurance I still need to pay $675.00 every month. It's unbelievable.

TJGuy profile image
TJGuy in reply to Southjersey318

how is your cost determined, is there a max out of pocket for a single drug or all drugs you might take?

what kind of Medicare plan do you have

Tall_Allen profile image
Tall_Allen in reply to Southjersey318

Beginning in 2025, the maximum amount anyone covered on Part D or Medicare Advantage will have to pay out of pocket for prescription drugs each year will be $2,000.

cesces profile image
cesces in reply to Tall_Allen

Yes. It's about time isn't it.

And the following year they get to start negotiating, in small increments, drug prices... unless that power gets removed by a new legislature.

NecessarilySo profile image
NecessarilySo

My out-of-pocket cost for Lupron is nil. Thank goodness for hospitals, insurance, and dedicated hospital workers. I probably wouldn't be here without them.

reichel profile image
reichel

that is horrible but it varies based on your plan. I am charged around $80 per shot. I am on a Blue Cross Medicare plan which has been great. It is crazy that it varies so much

B8ssist profile image
B8ssist

I am also surprised that Eligard wasn’t mentioned. My cost per injection hasn’t been bad.

B8ssist profile image
B8ssist

does anyone know what the price would be in Canada? I understand there was a big issue about people going over the border from the United States into Canada to purchase their medicines, which were sold to Canada by the United States pharmaceutical companies, and at a very reduced price.

Tall_Allen profile image
Tall_Allen in reply to B8ssist

I think Zoladex or Eligard are more widely used in Canada.

Maxx2006 profile image
Maxx2006 in reply to B8ssist

Lupron is $ 1500 every 90 days which i have coverage for via benefits or that I turned 65 this year that has kept me covered in Canada.

Vynbal profile image
Vynbal

and yet NPR has an agenda is not a political reply?

cesces profile image
cesces

Sheesh

1. Who nominates the judges that permit the legal bribery?

2. Who managed to get Medicare drug negotiation passed without a single opposition vote?

3. You rebut nothing that I said. Not one thing. I chose my words carefully and with precision.

"We have met the enemy and he is us"

Please consider rereading what I said, and then deleting or at least editing your post... though I guess some will find emotional comfort in it as is.

Thank you

Desrochers profile image
Desrochers

Im up in Canada, Ontario to be more exact. I get Eligard every 4 months. I’m over 65 so its free. I saw the cost of the drug that is charged to the government I think it was around $200. Thats in Canadian $ so in USD it would be around $1.50. At the price Americans pay for this prescription it may be a good idea to see if you can get a referral to have a Canadian doctor prescribe/inject and pay directly for the cost of the drug/service.Of course not be possible ( bet it is though) worth a try.

Here is how it works up here. The prescription is sent by the Dr to the pharmacy, renewals are on the prescription. You go to the pharmacy and pick it up. If it needs to be refrigerated take a cooler and the pharmacy will give you an ice pack. Pay the pharmacy ( in Canadian $ ) and go see the Doctor, the doctor will mix it and inject it and you will pay a charge Way Way lower than at home.

Here is a nice bit. If you want more of your prescription remember the repeats? Yes tell the pharmacy you will be away for 6 months they will allow you to take the repeats, now remember the cooler you may need it.

edgeh profile image
edgeh in reply to Desrochers

HI Desrochers, l'm now in Ontario and pay $100 per year for prescriptions, my age, 79, so not exactly free but still fantastic thanks to the health system in Canada.

My initial treatment in Mexico for 4 years was Eligard injection every 6months, cost of Eligard 9000pesos or $600 Canadian. Urologist visit and one hour consultation, $50. Americans without insurance should consider visiting Mexico

Teacherdude72 profile image
Teacherdude72

Seems like costs are all across the field. I have a Medicare plan with MVP and my monthly Lupron shot in the infusion center costs me $36.30. Before insurance coverage and adjustments cost was $1,350.00

Cooolone profile image
Cooolone

People will and should post their thoughts and opinions, regardless of whether or not someone else is interested. Respectfully, I find it more offensive that some should feel empowered to tell others what they should do, or think they're speaking for others when trying to control what others do.

If we don't like what we see, we have a choice to, and that is to not engage. Move on... Which is just as a legitimate suggestion as telling others what is or isn't acceptable

I say, post away... Have fun, let us know your thoughts. I've been enlightened multiple times while wading through some subjects I thought I had a concrete opinion on, only to be motivated to investigate deeper based upon others thoughts and opinions. Yes, even politics and the industrial medical community, lmao.

That enlightenment would have never occured had the censors ruled!

:)

Best Regards

Cooolone profile image
Cooolone

Thanks for posting! Always compelling and challenging to consider this subject.

Best Regards

spencoid2 profile image
spencoid2

It is insane that we pay these costs in the US. I was on Firmagon until I had a bilateral orchiectomy. I was visiting my father in Paris and needed a shot since I was there for over a month. I visited my father's primary care doctor. He proscribed the drug which I picked up at the pharmacy. The total cost including an EKG was about $200.At the cancer center in the US the billed charge was more like $12000. I imagine the costs are similar for Lupron.

Every one of the last several presidents has said they would get prescription drug costs under control. Ho long do we need to wait?

Tall_Allen profile image
Tall_Allen in reply to spencoid2

2025

spencoid2 profile image
spencoid2 in reply to Tall_Allen

ok that is my goal to live long enough :)

cesces profile image
cesces in reply to spencoid2

The trick is to watch what they do, not what they say.

anonymoose2 profile image
anonymoose2

Many of us are just jealous that we didn’t get our degrees in chemistry and research in the medical field.

Life is good.
cesces profile image
cesces

Please stay on the topic of medical costs. Please don't use it as an excuse to bring in extraneous political belief systems

Thank you

Gl448 profile image
Gl448

Eligard 6 month injection at Providence in Los Angeles with UnitedHealth as insurance:

Billed to insurance: $3312.

Amount Allowed: (negotiated price): $1434.18

Insurance Paid: $1219.05

Patient Responsibility: $215.34

I tried to find a CoPay Assistance program for Eligard, but none available I found.

cancerfox profile image
cancerfox

I got my Eligard injections at a urologist's practice. I am enrolled in a Medicare Advantage HMO plan, and for my last 6 month Eligard shot my plan was billed $7200. My plan approved $867 of that, and my share was only $175. There never seems to be much correlation between what plans are charged and what they actually pay. And hospitals are the last place to have anything done unless you absolutely have no choice (cost-wise and possibly infection-wise). 🙄

cesces profile image
cesces in reply to cancerfox

"And hospitals are the last place to have anything done unless you absolutely have no choice."

For anything that cuts flesh or is in any way dangerous, I prefer a teaching hospital.

WSOPeddie profile image
WSOPeddie

Greedy Pharma, doctors and hospitals. What else is new.

RMontana profile image
RMontana

Tall_Allen, in Panama my 3 month shot was $650 and my 6 month roughly double that at $1200...in the USA the insurance system would blow that up 10 times probably...but that was the actual cost of the meds with a credit card at a pharmacy...the doctor charged $12 for mixing and injecting...to give you an idea...TNX

slpdvmmd profile image
slpdvmmd

Lupron has always been outrageously priced. I started out as veterinarian then went to medical school. Lupron was and is used in birds and ferrets for reproductive and adrenal disease. It was outrageously expensive back the even in that setting. Now that I am on it I am not only outraged by my bill and EOB every three months that lists not only the cost of Lupron/Eligard but also the injection charge (coded as chemotherapy administration) which is usually performed by a medical assistant. I initially tried to address this by talking to my MO and BC/BS and suggesting I just get my labs and then they mail me the drug and I or anyone in my family could inject me. After much discussion BC/BS said they only do that in situations like where the patient lived in some remote site in Alaska. The drug pricing in the US will not change IMO despite what the politicos say. Private industry runs CMS, which is only a money collection agency, and they (private industry) will always be 7-10 steps ahead of the corrupt body we call congress. Also things are always maximally expensive in an academic institution (sadly where I spent many years of my professional life participating in such thievery)

cancerfox profile image
cancerfox in reply to slpdvmmd

My urologist's office tried to charge a ridiculous $143 for the 30 seconds it took to administer my Eligard shot, which they called "hormonal anti-neoplastic chemotherapy administration." My insurance allowed $31 of that, which I was supposed to pay but never got billed for because I think it must have been included in the $40 office visit fee I paid that day.

Slowcooker profile image
Slowcooker

WoW! Reading this thread is scary. I live in Australia and finished my 2 year term on LUCRIN 22.5mg every 3 months= ( LUPRON) June '22. I paid $5:60 AUD for each shot, but that rate is subsidised by the government plus my radiotherapy and all scans, blood tests, GP visits, Hospital stays ie Biopsy, Gold seed implants (target for radiation beam), all free. But of course I paid for medicare all my working life, still I am delighted with it. I was treated as a public patient as when I lost my job I had to drop my private health insurance as too expensive...then bang on time I got cancer!

Nugger profile image
Nugger

I needed a cardioversion, takes 10 minutes, quotes 114,000 us dollars but because i had no insurance, they said they would do it for 14,000, flew back home to England, had it done for free, wife is FL native & won't emigrate, told her she's crazy!

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