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Cost of Yervoy?

Forums General Melanoma Community Cost of Yervoy?

  • Post
    becky62
    Participant

      I've had two in fusions of Yervoy and I have received the first claim submitted to my insurance company.  My provider charged my insurance company over $205,000 for one infusion.  My insurance company has a contract with the provider for $102,000 for one infusion.  My dosage was 336 mg.  I thought this drug was about $30,000 for 200mg.  Is this normal for providers to charge this kind of money for drugs?

      I've had two in fusions of Yervoy and I have received the first claim submitted to my insurance company.  My provider charged my insurance company over $205,000 for one infusion.  My insurance company has a contract with the provider for $102,000 for one infusion.  My dosage was 336 mg.  I thought this drug was about $30,000 for 200mg.  Is this normal for providers to charge this kind of money for drugs?  I am shocked.  My insurance has a yearly cap of $250,000.  I'll run out of coverage with my 3rd infusion.  Any advice or help with this kind of situation would be greatly appreciated.

    Viewing 2 reply threads
    • Replies
        NYKaren
        Participant
          Amy, that seem so high! My last infusion was July 2012, and then the negotiated price was around $23,000/infusion. I know drug prices have gone up…I’d be very curious to hear from others who’ve done Yervoy in 2013. BTW, did you have to get prior approval? I did not for Yervoy (at the time) but I did for Zelbarof–around $11,000/month.
          Karen
          Are you sure it’s $102k PER INFUSION?
          NYKaren
          Participant
            Amy, that seem so high! My last infusion was July 2012, and then the negotiated price was around $23,000/infusion. I know drug prices have gone up…I’d be very curious to hear from others who’ve done Yervoy in 2013. BTW, did you have to get prior approval? I did not for Yervoy (at the time) but I did for Zelbarof–around $11,000/month.
            Karen
            Are you sure it’s $102k PER INFUSION?
            NYKaren
            Participant
              Amy, that seem so high! My last infusion was July 2012, and then the negotiated price was around $23,000/infusion. I know drug prices have gone up…I’d be very curious to hear from others who’ve done Yervoy in 2013. BTW, did you have to get prior approval? I did not for Yervoy (at the time) but I did for Zelbarof–around $11,000/month.
              Karen
              Are you sure it’s $102k PER INFUSION?
                becky62
                Participant

                  Yes, I've been on the phone with my insurance company and the Cleveland Clinic where I received the drug.  The negotiated amount is $102,000 per infusion.  When I initially looked at the claim I thought it might have been for all 4 treatments, but htat's not the case.  I did not have  to get prior approval.  I'm thinking maybe it would be cheaper to go out of network.  Can anyone tell me if I can call other hospitals and ask what the price would be?  I'm thinking maybe going out of network would be cheaper.  I'm just at a loss as to what to do at this point.  I'm scheduled for my third infusion on Tuesday.  I have asked for an itemized bill and put an appeal on the claim.  Tomorrow I am going to get a case manager at the insurance company and talk to a financial counselor at the clinic. I should have done all this at the time of diagnosis.  I did ask my oncologist at the time we agreed to go ahead with the yervoy if what I was reading at the time of around $30,000 was correct and he said he didn't know, but was probably in line with other drugs in that category of thousands of dollars, not hundreds of thousands of dollars.   

                  becky62
                  Participant

                    Yes, I've been on the phone with my insurance company and the Cleveland Clinic where I received the drug.  The negotiated amount is $102,000 per infusion.  When I initially looked at the claim I thought it might have been for all 4 treatments, but htat's not the case.  I did not have  to get prior approval.  I'm thinking maybe it would be cheaper to go out of network.  Can anyone tell me if I can call other hospitals and ask what the price would be?  I'm thinking maybe going out of network would be cheaper.  I'm just at a loss as to what to do at this point.  I'm scheduled for my third infusion on Tuesday.  I have asked for an itemized bill and put an appeal on the claim.  Tomorrow I am going to get a case manager at the insurance company and talk to a financial counselor at the clinic. I should have done all this at the time of diagnosis.  I did ask my oncologist at the time we agreed to go ahead with the yervoy if what I was reading at the time of around $30,000 was correct and he said he didn't know, but was probably in line with other drugs in that category of thousands of dollars, not hundreds of thousands of dollars.   

                    becky62
                    Participant

                      Yes, I've been on the phone with my insurance company and the Cleveland Clinic where I received the drug.  The negotiated amount is $102,000 per infusion.  When I initially looked at the claim I thought it might have been for all 4 treatments, but htat's not the case.  I did not have  to get prior approval.  I'm thinking maybe it would be cheaper to go out of network.  Can anyone tell me if I can call other hospitals and ask what the price would be?  I'm thinking maybe going out of network would be cheaper.  I'm just at a loss as to what to do at this point.  I'm scheduled for my third infusion on Tuesday.  I have asked for an itemized bill and put an appeal on the claim.  Tomorrow I am going to get a case manager at the insurance company and talk to a financial counselor at the clinic. I should have done all this at the time of diagnosis.  I did ask my oncologist at the time we agreed to go ahead with the yervoy if what I was reading at the time of around $30,000 was correct and he said he didn't know, but was probably in line with other drugs in that category of thousands of dollars, not hundreds of thousands of dollars.   

                      awillett1991
                      Participant
                        Whoa, that is a lot. So unfair, I’m sorry. I finished mine in Dec and it was billed to our ins at 55k per infusion and took over 3 wks to get approved. My onc didnt have any idea what it would cost either. I don’t see what it would hurt to call around.

                        Have you looked into the yervoy copay program??

                        http://www.yervoy.com/patient/paying-for-yervoy.aspx

                        awillett1991
                        Participant
                          Whoa, that is a lot. So unfair, I’m sorry. I finished mine in Dec and it was billed to our ins at 55k per infusion and took over 3 wks to get approved. My onc didnt have any idea what it would cost either. I don’t see what it would hurt to call around.

                          Have you looked into the yervoy copay program??

                          http://www.yervoy.com/patient/paying-for-yervoy.aspx

                          awillett1991
                          Participant
                            Whoa, that is a lot. So unfair, I’m sorry. I finished mine in Dec and it was billed to our ins at 55k per infusion and took over 3 wks to get approved. My onc didnt have any idea what it would cost either. I don’t see what it would hurt to call around.

                            Have you looked into the yervoy copay program??

                            http://www.yervoy.com/patient/paying-for-yervoy.aspx

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