Gamma globulin infusion cost in USA? - CLL Support

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Gamma globulin infusion cost in USA?

pragnar profile image
15 Replies

Hi

I just got a bill from my doctor for gamma globulin infusion. The cost is 10, 288 USA dollars. Is this a normal cost? Could you tell me what are other hospitals charging? Sad thing is that nobody told me before the treatment what the cost is. I have insurance but have to cover portion of the treatment.

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pragnar
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15 Replies
Panz profile image
Panz

These figures are from a FL Cancer center

Nov, $4,438.00

Dec. $4,714.00

Jan. $4,632.00

Feb, $5,163.00

Each month is varies depending g on what lab work is run that month.

I don’t have numbers for the IVIG that I have done in the summer in MI but the numbers are higher by how much I am not sure. In MI I get them at a Cancer Center affiliated with a hospital.

I hope this gives you an idea. All the best to you. I have had IVIG every 4 weeks for two years and just this month I reached 900 which is in the normal range...two years ago I when I started I was 200. Then keeps me in a safe place. 🙏☘️💕😍

pragnar profile image
pragnar in reply to Panz

Thank you.

Panz profile image
Panz

PS....my total costs done at both locations are totally covered by Medicare and united Health Care. 🙏☘️💕😍

MsLockYourPosts profile image
MsLockYourPostsPassed Volunteer

Charges for infusions like IVIG seem to involve some game that the patient is never made aware of. Mine is covered 100% by Medicare, but the statements sent to me can vary quite a bit. Try calling LLS 1-800-955-4572 and asking about co-pay assistance. They can advise you about their program, and others available.

Ellieoak profile image
Ellieoak

Yes that is what it is mine is covered by Medicare and Atena. You can call leukemia & lymphoma society to help pay for it.

BeckyLUSA profile image
BeckyLUSA

My final “cost” that is covered by Medicare and BCBS supplement is around $8500 each time. I have never had to pay a dime. ( for anything).

BeckyL USA

maggiesgrandmom profile image
maggiesgrandmom in reply to BeckyLUSA

Good to know.

lelliottaeten profile image
lelliottaeten

That is about what I was billed. I live in the North East Section of the US

maggiesgrandmom profile image
maggiesgrandmom

Hi I have to go to my local hospital in Pa. They billed the insurance $44k and insurance paid $22k!!

pragnar profile image
pragnar

Did anybody tried subcutaneous infusion therapy? If yes what Medication and the cost?

johnl profile image
johnl

In December, hospital charged 8,360 Medicare approved 8,360 , but only paid 1,363 and united healthcare paid 350 I pay nothing.

john

uihwki profile image
uihwki

I'm still on commercial insurance. My insurance company was billed $9233. The discount was $5881. That left a payment due of $3352. Since I have a high deductible plan (deductible = $4500) I'm on the hook until my total out of pocket exceed $9000. When I exceed that amount the insurance company picks up 100% of the cost.

dwolden profile image
dwolden

It’s insane isn’t it. That’s what our insurance was paying.

larrymarion profile image
larrymarion

In 2014 I had nine gamma globulin infusions in a hospital as part of an emergency treatment for ibrutinib side effects. Doctor warned me that it would be a fight to get insurance to pay for it and he was right. I don't remember the numbers from five years ago but my otherwise generous private insurance company did balk at covering the cost--no Medicare for me at the time. My hemoc had to do a song and dance with the insurance company--other treatments had failed, my only hope, etc. -- to get it covered. Finally the insurance company relented and paid the bill. Definitely ask your doc to fight the good fight, since IVIG infusions will prevent even more costly treatments down the road.

SeymourB profile image
SeymourB

I am on Cuvitru SCIG (Subcutaneous, not IV), 4 infusions a month of 10mg 20% IgG.

MyIgSource, a part of the manufacturer, Shire Pharmaceutical, bills my BlueCross/Blue Shield insurance about $14,000/month. The insurance company agreement with the PBM (Pharmacy Benefits Manager), Accredo, discounts it down to about $6000/month. On my insurance plan, it's considered Medical, not Drug. My copay has been covered by a $5K/year assistance coupon from the manufacturer, Shire through MyIgSource. I have a $4K/year maximum out-of-pocket limit. So I've never paid a co-pay.

I believe that all such products have similar payment assistance programs.

The sleight of hand with the list price and the "discounts" is one of the key illusions in the American healthcare system. Imagine buying a car - list price $100K, but because YOU are our special friend, we'll give you a $70K discount, and you pay "only" $30K. Of course, your friend is not so special, because they negotiated through a different company, so they pay $35K for the same car.

The cost is related to supply. We do need more donors.

primaryimmune.org/news/ig-a...

Recently, my daughter has seen advertisements at college for student donors to help pay for school text books. In the U.S. donors are paid for plasma donation, while whole blood is usually an unpaid donation through the Red Cross. Paid donations are a controversial ethics issue. Donors are not a cross section of the patient community in any case.

Even though our situation with CLL is actually a secondary immune deficiency,

en.wikipedia.org/wiki/Immun...

I find that the above Primary Immune site has a wealth of good info for doctors and patients who want to shop around, but need to know the differences in product formulations. They have a nice chart showing 12 products, as of a year ago:

primaryimmune.org/sites/def...

Someday, polyclonal Ig products like IVIG and SCIG will be produced totally in a lab, similar to monoclonal antibodies, and not require a continuous supply donors. It remains to be seen whether the price goes up or down at that point. I can foresee a menu of disease formulations localized for areas of the world and times of the year.

Another trend I read about is collections of monoclonal antibodies specific to particular diseases. With CLL, penumococcal pneumonia has been identified as perhaps the greatest risk. But then, there are not easy ways to assess some viral risks in an immune compromised patient. I haven't seen monoclonal antibodies for pneumococcal pneumonia yet.

Here's an article which lists some therapeutic antibodies for specific diseases:

ncbi.nlm.nih.gov/pmc/articl...

It doesn't talk cost, though. Some of the diseases have much cheaper alternative drugs for prevention, such as acyclovir for varicella.

Another thing affecting price is where the product is manufactured. The the box for the Cuvitru that I use says it is a product of Belgium. The Ig may be sourced and processed elsewhere, though. I know that Baxter (which is a subsidiary of Shire, which is now owned by Takeda) has facilities in Puerto Rico that were affected by hurricane Maria. Pharmaceuticals are an international affair.

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