Daughter has very poor health insurance. She is 42 and has been given FOSAMAX because of bone loss ---she had a total hysterectoy at 34 and has been on no hormone replacement since. Curious as to how much it would cost out of pocket for once a year RECLAST
Hi debruno, welcome and thanks for your question. Sorry about your daughter having bone loss so young.
If you know where you can get this infusion, you can call the billing office and ask what the price would be without insurance. The only figures I have are from 2007, so the price probably has changed.
In 2007 the Reclast retail price was *approximately* $800.00, plus you have to add the cost of the infusion on to that so that would make it more. You can also call 1-866-RECLAST and ask this question to get a more up-to-date price.
Novartis also has a patient assistance program for those without insurance and you can check that out at 1-800-245-5356 or log on to www.pap.novartis.com for more information. While your at the Novartis site, click on the Home page and see the link for "Looking for an infusion Center Near You" and you can find out the closest center in your zip code.
Good luck and if you have any other questions just re-post.
I just had a 30 minute infusion of Reclast and my health insurance company was billed $17,000.00+. I was shocked by the price. My Blue Cross policy paid $2000.00 of the charge and I was not responsible for the remaining. Geeeez, we sure need health reform. All I can figure out is that the health care provider must have just pulled this price out of thin air!
How were you not responsible for the remaining balance?
I just had a reclast infusion on 7/13/2010. The charge for the medicine alone was over $3,000; the total cost of the infusion was over $4,000. I was told by the doctor that the cost to me would be about $60. I am now looking at a bill from the hospital for over $500. The doctor isn't budging and says he did not tell me that, but he did! He said he would talk to the pharmaceutical liaison to see if the cost could be reduced, but if not, I would be responsible. I think this is a horrible misuse of my money and my insurance's money. I am perfectly capable of taking oral meds. I only did this at this doctor's suggestion. Do these doctors get a kick-back for recommending the drug?
I had an infusion of Reclast on August 19, 2010. The infusion site was moved from my Rheumatologist's office to the out-patient center of the hospital which is next door. They billed Medicare $10,010.37. (I also have a supplemental health policy with Blue Cross/Blue Shield). Medicare paid $9,818.91 and my insurance paid $242.96. I was also shocked by the cost. I have gotten infusions for Rheumatoid Arthritis in my doctor's office that cost approximately 1/4 or less than the cost for the Reclast. By getting the infusion in a section of the hospital, the hospital charged me for a room/bed, but I was actually in a large room (like a ward) that had screens between reclining chairs and I sat in a recliner chair while getting the infusion. We sure do need health reform. I won't be taking any more reclast, at least not as an out-patient at the hospital.
Wow this is incredible. Thanks for posting this! I'm glad MediC paid for most of this, but don't understand why it's so high! Of course this is not the price that the drug co is quoting...
It's my assumption the provider(doctor who provided the Reclast) is part of a practice that has a contract with the insurance provider. Almost all doctors have those agreements.
If so, there are pre-agreed upon maximums that may be charged for the medication, treatment etc. That means, even if you have lousy health insurance, with a high deductible(amount you have to pay out-of-pocket before the insurance company pays anything) the agreed upon maximums will keep you from having to pay what an uninsured person pays. Of course, some doctors and hospitals will reduce their charges...some won't. But, $17000!!!! That's absurd and, surely, is a mistake.
I had spinal surgery. The original bill total was over $100,000. I nearly fainted when I saw it. Then, the insurance was filed and the agreed upon amounts reduced the bill total by 70%. Then, they paid 80% of the remaining balance, $30,000. I had to pay the remaining balance, which was about $6000. That's still a lot, but...it was a vast relief after see the original $100,000.
Everyone's insurance is a little different...and mine is private...not part of a group plan.
Yes, there is an incentive to prescribe new medications. The USA should be ashamed of itself for allowing this sort of business. It's unethical and hurts everyone.
On reclast website they claim the cost is just $60! My insurance got billed $5000 by MGH. What a scam.
This is the page where Reclast claims the infusion cost is $60.
The cost of Reclast depends on what your insurance copay might be. If you're asking what the retail cost is, you'll have to contact the infusion center where you would receive this and ask them to give you a "break-down" of all the charges.
At infusion centers, usually in a hospital, there could be charges for the out-patient room (actually an area with curtains), infusion charges, drug charges and any ancillary charges the hospital/doc's office may charge.
I would not count on the price listed at Novartis (manufacturer) or anyone else who estimates this. There could very well be 4-5 different charges, for one infusion, based on location (infusion center) your insurance allowance, i.v. charges and possibly nurse/technician charge.
The hospital must supply this information to you, so call and find out, since there's no way to guess about it.
Good luck to you!
So you are saying, Pam, that it is acceptable that reclast costs $60 as claimed by the supplier and providers can charge anything they can get from the payers for delivery? Up to $17,000 for delivery by Rolls Royce?
I had the (15 minute) Reclast IV infusion in December 2009. My insurance company was charged over $8,300.00.
I cannot believe it is this expensive. I am searching for more information. After calling Novartis, they simply direct me to my insurance company.
Hi, sorry you are having this problem. I know they aren't charging that much for Medicare recipients so I just don't understand the price they charged. You aren't the only one with this problem and I would try to find out how a company can charge an extremely different price for different insurance co's. I would also have your Dr. try and help you with this since it doesn't seem right to me. Can you file an appeal about the price? In your insurance manual there should be instructions on how to do this since we all have the right to appeal the cost, or other issues with our treatments.
Good luck and let us know if you resolve this. MC charges around 1200.00 for the infusion.
Thank You Pam for responding.
Right now I am waiting for two things:
I called the provider, who billed my insurance company, and they are researching the cost. They told me they did not have the information on the dosage that was given. Odd, that they billed on an item without that information?
I have a call into the IV infusion clinic to receive the exact details of what was billed.
I will then file an appeal with Aetna and indicate the vast descrepancy in cost of this procedure.
I will keep you posted on my progress. Thanks again.
Did you or anyone else obtain a more palatible cost for Reclast? I had the fifteen minute infusion treatment this past April and was billed $6443.50 for the pharmaceutical charge alone. Blue Cross Blue Shield did reduce the cost by $2598, but this is still an outrageous cost in my mind for this drug. I am currently disputing this exorbiant cost.
Hi Kurt, welcome...I agree with your statement, and would love to know what you find out from your insurance co. The drug co. doesn't give a price on this, but they do say that most insurance co's/Medicare cover it. That said, we keep getting more and more posts like this and I don't understand it either. There are members that said the charge was roughly $1,200.00, so I don't understand the huge difference.
If I can find out any more on this I'll post it here.
Hey Kurt, here's a link to another members post from 2009, where she says she paid $340.00 for Reclast, it sounds like she has Medicare, but I'm not sure. You might want to connect with this member and see if she can explain her bill to you. http://www.healthcentral.com/osteoporosis/c/42605/20963/comments The members name is Lynne. You can send an email to her via the private messaging system.
And I was just talking to a friend who had Reclast last week. She's on Medicare. The bill was $20,900. Medicare paid just a tiny fraction of that. She's not responsible for paying anything. This is just crazy!
I just spoke to my Dr. and they are considering this, however at that price (I have insurance), it is a rip off to the insurance co's and us. Do you have to go to the hospital to have it? Maybe that way the Boneva injeciton would be better (every 3 months).
Is this crazy or what?
In Atlanta, December 2011, the cost was over $7000 at the Piedmont Hospital (Surgical Center on Howell Mill Road). Blue Cross/Blue Shield of Georgia paid a little over $4000, leaving me with a $2800 balance. (My doctor did not give me any indication of the cost.) Based on my research of the cost of the drug itself, this is about a $6500 "mark up" which is outrageous.
I had a Reclast procedure here at Rheumatology Associates of Indianapolis in April of 2013. They charged me $1500 plus $200 for the infusion (1 hour) only took 20 minutes. Anthem insurance paid the cliniic about 2/3rd of that. My out of pocket cost was $128. I thought I was getting overcharged. Now I see I wasn't!!!!!!!!!!!!
I believe the cost is whatever the hospital wants to charge and the Reclast makers don't care as long as they use their drug. Even on medicare I'm obliged to pay 10% of the Medicare part B drugs. So based on that... the hospital decides how much they need to meet their budget or building fund and jack up the prices to meet that amount.
I'm convinced if we don't get some congressional changes done in how we pay for medications the hospital systems along with their own self-serving insurance companies will continue to align with the pharmaceutical companies and make a mint while we all continue to pay through the nose.
HOW MUCH IS THE AVERAGE COST FOR THE RECLAST / ZOMETA INJECTIONS ! INCLUDING OFFICE VISIT ??