NPR expose on Lupron Depot pricing

[kreg001]

I’m not a fan of Lupron and am now on bicalutamide monotherapy but I’m still alive. I’m sure Lupron Depot helped. I was surprised to read this NPR story about Lupron Depot. FYI.

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

[rsgdmd]

Where I go, Lupron is billed at $20,024 for 3 mo. Lupron Depot and Independence Blue Cross paid $784; injection billed as $574 and they accepted $22.10. After my (high) deductible, I have no copays.

Surprised that United Healthcare's accepted rate is so high.

[chickgreen]

I've seen that 'expose'as well and wonder at the pricing. For me, near Seattle a 3 month Lupron is billed at about $8,000 (I'm paying nothing this year, as I managed to exceed the out-of-pocket limit)

The whole thing is a racket, and unfortunately it would seem that the major beneficiaries are the people writing the laws.

[Lrv44221 in reply to chickgreen]

Or the drug companies? maybe both?

[reichel]

I am in Boston and I am paying $80 a shot as copay. Medicare patient and I normally don't look at what was billed., but think it is much less than mentioned.

FYI, my Abiraterone copay is 61 dollars a month and that is 25% of what the plan is paying. Initially wad told 242 per month.

Our drug prices are ridiculous in the US. Pharma gets big bang for their lobbying

[BanjoPicker]

I had my first 4 month Eligard shot in July. I have a Medicare Advantage Plan by UnitedHealthcare. The provider billed $3,104. The plan paid $539. I paid $135. The agreed effective cost was $674.

[Gl448 in reply to BanjoPicker]

The six month Eligard injection through my commercially provided UnitedHealth plan was similar:

Billed to insurance: $3312. Amount Allowed: (negotiated price): $1434.18 Insurance Paid: $1219.05 Patient Responsibility: $215.34

Crazy what the bargaining power of Medicare is I guess. Almost the exact same starting price, but the total paid to the provider for yours was less than half of mine through the same UHC services insurance.

[Gl448]

There was a rather lengthy thread on this just a few days ago. Part of it turned into a nasty politics back and forth, but still an interesting read.

healthunlocked.com/advanced...

[kreg001]

thanks. Didn’t mean to plow what has already been plowed.