This is a place to discuss concerns, tips and strategies for all types of side effects from all types of medications and treatments, (chemo/rads/hormonal/targeted/pain meds/etc.
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Oct 19, 2008 02:50PM
Otto, NC
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Wink
wrote:
I just got my explanation of benefits yesterday and my insurance was charged $9000 for the Neulasta shot that I received. I heard that it was ~$3000; $9000 is absolutely crazy
!!!!!!!!!
How much were you all billed for Neulasta?
Donna
Donna "There Are No Accidents"
Dx
7/25/2008, IDC, 3cm, Stage IIA, Grade 3, 0/3 nodes, ER-/PR-, HER2-
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azsunn
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Oct 19, 2008 03:32PM
azsunn
wrote:
I just pulled one of my EOBs and it shows amount billed 5280, allowed amount 3016.76.
It's crazy, what really gets me is the people that don't have insurance and are billed the full amount not the discounted amount.
~Kath
Dx
11/20/2007, IDC, 1cm, Stage IB, Grade 3, 0/4 nodes, ER+/PR+, HER2+
NancyD
NY
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Oct 19, 2008 03:46PM
NancyD
wrote:
I wish my EOB's were more detailed. They don't actually say WHAT each amount is for...they do not say "Neulasta" or "saline IV". And my onc is so slow in billing that it might be a month or more before it shows up.
But from what I can figure out by the dates, my Neulasta ran @ $3000.
Life is good. It's not perfect. but it's good.
Dx
2/22/2008, IDC, Left, Stage IIIA, Grade 2, 4/10 nodes, ER+/PR+, HER2-
Chemotherapy
3/21/2008 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Surgery
7/10/2008 Mastectomy: Left; Prophylactic mastectomy: Right
Hormonal Therapy
8/31/2008 Arimidex (anastrozole)
Radiation Therapy
9/4/2008 Breast, Lymph nodes
Surgery
1/27/2010 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
Wink
Otto, NC
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Oct 19, 2008 07:03PM
Wink
wrote:
It's absolutely insane - and why the big spread in pricing? I'm going to talk with our benefits specialist tomorrow; I work at the hospital that is charging me so much!
I could cry for the people that don't have insurance; I was told that most of them end up in bankruptcy; so very sad
.
Donna "There Are No Accidents"
Dx
7/25/2008, IDC, 3cm, Stage IIA, Grade 3, 0/3 nodes, ER-/PR-, HER2-
JulieC
Charleston, IL
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Oct 19, 2008 07:22PM
JulieC
wrote:
Hi Wink,
My Neulasta shots were about $6700 - $6900. Each chemo treatment + the Neulasta shot was about $15,000 per session and the shot made up almost half! But, my onc told me that if I would have ended up in the hospital with an infection, a week at the hospital would have cost around $50,000. I guess everything is relative.
Julie
Dx
3/25/2008, IDC, 1cm, Stage I, Grade 3, 0/3 nodes, ER-/PR-, HER2-
sue_blue
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Oct 19, 2008 08:35PM
sue_blue
wrote:
I had an option of getting the shot at two different sites. One, closest by, charged $7,000, and one 20 miles away charged $3,000. I drove to get the shot. I couldn't believe the cost and the difference. We did decide cost might have something to do with affiliation and ability to purchase in bulk.
Susan
mommy3abm
Tyler, TX
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Oct 19, 2008 09:09PM
mommy3abm
wrote:
My Neulasta was billed at 6700.00 no matter what my dosage was. The first one I had 6 units and the last 3 I only had 3 units, but the billing was the same. Go figure!
neoadjavant chemo. TAC x4, lumpectomy, rads, tamoxifen, BRAC1/2 neg
Dx
7/15/2008, IDC, 2cm, Stage I, Grade 1, 0/4 nodes, ER+/PR+, HER2-
pinkisit041…
laurel, ms
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Oct 19, 2008 09:38PM
pinkisit0415
wrote:
well girls -- mine was only $200.00 at onc office next day after chemo -- yeah
however had a delay in last chemo treatment and had to go to hospital and
OMG !!!!!!!! $7349.00 and I stood in a hallway and waited 2 hours and shot was given in hallway took all of 10 seconds ??? they are just using our ins benefits up GRGRGRGR
Pink

LIVE, LOVE & LAUGH
Dx
5/13/2007, IDC, 2cm, Stage IIIB, 3/18 nodes, ER+/PR+, HER2+
Wink
Otto, NC
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Oct 20, 2008 12:18PM
Wink
wrote:
It was confirmed; the shot indeed was $9000.00. I checked with my onc's office and they charge $3200.00; needless to say, I will drive the 20 miles for the shot if needed. I don't understand why it costs more in the hospital as opposed to the onc's office.
Donna "There Are No Accidents"
Dx
7/25/2008, IDC, 3cm, Stage IIA, Grade 3, 0/3 nodes, ER-/PR-, HER2-
wendyk13
South Elgin, IL
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Oct 20, 2008 01:36PM
wendyk13
wrote:
Hi there....it's been almost 1.5 years ago but my onc charged $1800. for the neulasta...but the one day I had to go to the hospital on a Sat to get it.....$3800. with a "sitting" fee of $85.
I never did that again....also guess I should have stood up for the shot......
And $9000. is just totally crazy. A lot off-topic but DH was recently in the hospital and had a severe allergic reaction to the EKG leads, which we told them about and not to use the nickel ones. So...long story short they ordered up a tube of benadryl cream. $400.20 on the hospital bill. Jeepers...haven't they ever heard of WalMart??????
Wendy
Dx
11/20/2006, IDC, 1cm, Stage I, Grade 2, 0/7 nodes, ER+/PR+, HER2+
CanItBeTrue…
NH
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Oct 22, 2008 06:52AM
- edited
Oct 22, 2008 06:57AM
by
CanItBeTrueNH
Hello Ladies:
My insurance paid $3k per injection in addition my insurance had caremark (prescription card carrier) UPS overnight them to me at my office so someone could sign for them.(I work so wouldn't be home to receive the package-signature is required and they have to be placed in the fridge right away)
They where shipped 2 weeks before my chemo treatments.
$30.00 for my co-pay. The package included 2 needles packed in dry ice. Then we unpacked them and put them in the butter dish. Take it out of the fridge about a half hour before the 24 hours after chemo.... I inject the needle in my upper thigh.
The cost is relative to all of the research that went into it to develop the product. I should have went to college for Nuclear Medicine :) .
Dx
9/4/2008, IDC, 2cm, Stage II, Grade 2, ER+/PR+, HER2-
debk55
Mi
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Oct 22, 2008 07:16AM
debk55
wrote:
HI All,
My Onc office told me the amt charged has to do with the location the shot is given and the coding it is billed with. Mine is covered at the onc office as part of chemo, but not covered at all if given at my pcp office or if i give it to my self which sucks as I live 75 miles away from onc.
Prayers and good thoughts to all of you a good day, Debk:)
Deb :)
Dx
9/9/2008, IDC, 2cm, Stage II, Grade 3, 0/6 nodes, ER-/PR-, HER2-
flash
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Oct 22, 2008 07:17AM
flash
wrote:
The cost is because of the research cost developing it. It is worth every penny. My insurance bill paid 3000 of the 9000 billed.
multifocal multicentric IDC, DCIS, pagets et al. - er+,pr+ her2+++, mast,chemo, ooph, hyst
Dx
10/10/2007, Paget's, Grade 3, ER+/PR+, HER2+
cmb35
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Oct 22, 2008 08:13AM
cmb35
wrote:
If I'm remembering correctly (big if!), the shots were $6000, and I paid $240 co-pay for each one. My onc prescribed them to me so I could do myself at home, but informed me when she did that the ins would deny it at first (they did), and then she submitted a form and they approved it. I don't think the pharmacist had dealt with it before, and he was a pain in the ass about it, I do remember that quite clearly!
Dx
5/27/2005, IDC, 1cm, Stage II, Grade 3, 1/15 nodes, ER-/PR-, HER2-
AlaskaDeb
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Oct 22, 2008 03:48PM
AlaskaDeb
wrote:
Mine was almost $9,000. They paid about $3,100 and the hospital wrote the rest off.
Deb C
familyroks
Bremerton, Wa
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Oct 23, 2008 10:14AM
familyroks
wrote:
Get this...If my Onc provided the Neulasta, with my insurance, I was obligated to pay 30% of the plan allowance PER DOSE. However, if I got it through a pharmacy I only have to pay my $30 co-pay for a month supply (2 doses). Gee...what SHALL I do?
So, I got it through the pharmacy and took it to my Onc's office so that they could give me the shot. I'm just so glad that I even looked into this. Many people have no idea that there could be a difference with what their plans cover and what their options are.
~Adrienne
Dx
4/3/2008, IDC, 2cm, Stage IIB, Grade 3, 1/8 nodes, ER+/PR+, HER2-
BFidelis
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Oct 23, 2008 04:09PM
BFidelis
wrote:
I got mine at my local pharmacy and self-injected. The 'cost' on the Rx label was about $3300; I paid a copay of about $100 per shot. When I told my dad, he said "what do people without insurance do?" I told him "they die."
carolynf
So Berwick, ME
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Oct 29, 2008 03:10PM
carolynf
wrote:
I thought the Dr's office messed up on the billing because my Neulasta shot was $12,150.00. I almost flipped when they told me that was correct! I had to pay $1800.00 but was shocked at the cost. My onc. also said it was expensive but didn't realize how much. I now know why my cousins wife in England was never given this shot when she went thru her treatments!
Carolyn
Dx
10/26/2007, IDC, 1cm, Stage I, Grade 3, 0/7 nodes, ER-/PR-, HER2-
mke
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Oct 29, 2008 04:11PM
mke
wrote:
Mine were about 2900 per shot in 2006, neopogen was about 200 per shot. I picked them up at the hospital pharmacy and my husband gave me the shots. I have good insurance so I didn't have to pay anything extra. The regular Ontario health insurance doesn't cover drugs although there is a special fund for major costs like neulasta.
jdg1
Rohnert Park, CA
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Nov 4, 2008 03:32PM
jdg1
wrote:
My insurance paid for my Neulasta shots in full $3,000.00
Infiltrating Ductal In-Situ Stage IIB Grade 1 No node involvment, ER/PR + HER 2 -, Oncotype DX 17
Dx
5/30/2007, IDC, 0/2 nodes
HopeForBest…
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Nov 10, 2008 05:53PM
HopeForBest
wrote:
Hello everyone,
Am new here and heading to bilat maste, chemo and rad.
All the terms are new to me. What are this expensive Neulasta shots?
Best wishes to all!
RRF
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Aug 11, 2009 06:34PM
- edited
Aug 11, 2009 06:35PM
by
RRF
My daughter has breast cancer and has been receiving a Neulasta shot after each chemo treatment. The cost is $9,375 per shot and is NOT covered by insurance.
Scoobydoo
Clarksburg, MD
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Aug 12, 2009 12:54PM
Scoobydoo
wrote:
Hi RRF. Has she asked about getting neupogen instead? I believe it is much cheaper. The down side is you have to give the shots yourself and you have to take it for about 5 days.
Started Chemo 9/17/09 Finished 1/4/10 TX 4 DD AC and 4 DD Taxol Started Chlodronate 1/28/10 , start rads 2/16/10
Dx
6/4/2009, 4cm, Stage IIA, Grade 3, 0/6 nodes, ER-/PR-, HER2-
mke
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Aug 12, 2009 12:59PM
mke
wrote:
Yes, do check into Neupogen. You have to have more shots but I found it easier. And that price is absolutely absurd.
concernedsi…
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Aug 12, 2009 01:22PM
concernedsis
wrote:
Sis' shots cost $5700 each - the cancer center took her insurance so now out of pocket thank God. If your insurance says not covered, be sure to ask why? Her first shot came up not covered because it was a medicine and would go to her pharmacy plan but once we explained it to them INJECTABLES are covered by the medical not pharmacy insurance and all 4 shots were paid for. Each shot was coded wrong and denied and required phone calls to fix but they were all covered. In addition, if not covered based on medical reasons - there should be an appeals process.
Last check www.amgen.com and look for the patient assistance program.
Sandygirl
North Ridgeville, OH
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Aug 12, 2009 01:29PM
Sandygirl
wrote:
I called the cancer center before I started Neulasta and the woman told me, "now don't get excited, but it is $12,000 each time you go to the hospital to get it. So I went to plan B and called Caremark and they told me it is $70 a month. They were excellent in sending the drug and providing help if needed. My son is in nursing school and I let him practice on me. One month I needed 2 injections and it still only cost $70. Would I be right in saying something is wrong with health care?
Sandygirl
Dx
8/25/2008, IDC, 1cm, Stage II, Grade 2, 2/15 nodes, ER+/PR+, HER2-
bluedasher
CA
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Aug 12, 2009 03:53PM
bluedasher
wrote:
I got Neupogen and was taught to inject it myself by one of the chemo nurses. Kind of weird the first time you do it, but not hard and not much pain if you do it in the abdomen where they show you because there aren't a lot nerves in that area. I needed 3 shots per chemo cycle. The pharmacy receipt showed the cost to my health plan at between $300 and 400 a dose (I don't remember the exact amount now because I just paid my usual drug copay).
The whole world is a narrow bridge and the main thing is to not fear.
Dx
9/2008, IDC, <1cm, Stage IB, Grade 2, 0/5 nodes, ER-/PR-, HER2+
Targeted Therapy
Herceptin (trastuzumab)
Surgery
Lumpectomy: Left
Radiation Therapy
Chemotherapy
Cytoxan (cyclophosphamide), Taxotere (docetaxel)
glostagirl
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Sep 3, 2009 05:58PM
glostagirl
wrote:
I've been in treatment all summer and received a Neulasta shot after each chemo infusion. It was billed to my insurance in the range of $11,500 to $12,500 each time. They covered it and paid 100% minus a 10% (whoppee) network discount. The Cytoxan and Taxotere chemo was also billed out in the $11,500 +/- range. Most recently I saw a charge for typical blood labs for $913.00. Yikes, it's no wonder our insurance premiums are going up and up and up!
...."We must see all scars as beauty. ....Because take it from me, a scar does not form on the dying. A scar means, I survived." Chris Cleave, Little Bee
Dx
1/5/2008, IDC, 2cm, Stage IIA, Grade 3, 0/2 nodes, ER-/PR-, HER2-
Surgery
2/21/2008 Lumpectomy: Right; Lymph node removal: Right, Sentinel
Surgery
3/26/2009 Lymph node removal: Right, Sentinel; Mastectomy: Right; Reconstruction (right): IGAP flap
Surgery
6/19/2012 Reconstruction (right): DIEP flap
Surgery
11/13/2012 Reconstruction (right)
unklezwifeo…
Union County, NJ
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Sep 23, 2009 01:31AM
unklezwifeonty
wrote:
The price the pharma co charges has nothing to do with research cost. They charge the highest price they can get.
Lumpectomy 8/2009. Chemo Start 9/2009. 4 DD ACB -> 4 DD Abraxane (Taxol Reaction) + Zometa
Dx
7/2009, IDC, 3cm, Stage IIB, Grade 3, 1/9 nodes, ER-/PR-, HER2-
unklezwifeo…
Union County, NJ
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Sep 23, 2009 01:34AM
unklezwifeonty
wrote:
My prescription plan is being a PITA. They need the doctor's office to get Neulasta pre-approved but only if I want to pick it up at the local pharmacy for at home self injection. Go figure!
Lumpectomy 8/2009. Chemo Start 9/2009. 4 DD ACB -> 4 DD Abraxane (Taxol Reaction) + Zometa
Dx
7/2009, IDC, 3cm, Stage IIB, Grade 3, 1/9 nodes, ER-/PR-, HER2-
unklezwifeo…
Union County, NJ
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Sep 23, 2009 01:35AM
unklezwifeonty
wrote:
Once you get to 5-6 shots of neupogen, it begins to cost about the same as neulasta.
Lumpectomy 8/2009. Chemo Start 9/2009. 4 DD ACB -> 4 DD Abraxane (Taxol Reaction) + Zometa
Dx
7/2009, IDC, 3cm, Stage IIB, Grade 3, 1/9 nodes, ER-/PR-, HER2-