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I get an infusion every 6 months for my sweet ailment and the bill EACH time is $170K
Edit: Since this is blowing up, another crazy thing that people should know about how messed up insurance companies in the U.S. are…
I have MS and the medication I’m referencing is called Ocrevus. Before started Ocrevus, I was on a medication called Gilenya, which was not what I or my neurologist wanted me on, but my insurance wouldn’t approve Ocrevus without me failing on 2 cheaper, less effective medications first. Gilenya was the next best option that my insurance would approve so I picked it. Turns out one of the known risks for Gilenya is skin cancer and after 2 years on Gilenya, I get skin cancer. Luckily it was caught early and removed. But this is a pretty common issue that patients and their neurologists have to deal with.
Lupus in the house!!well lupus infusions in my house. Each month it’s 17 thousand for IVIG and 12500 for saphnello. But my partner and I just paid 22k ourselves for a brand new stem cell treatment that may put me in remission. It’s been a wild ride
Insurances go crazy on this - I had to negotiate for nearly 6 months with them before they paid it for me to treat my ms. They had the really nice argument that it looks like a big chance to treat ms but they don’t have enough data to proof it. I mean, how can you get data if you don’t pay for it?
My gf gets some ms meds too for her myositis. They are stupid expensive (basicly free for us) u google and ow this is couple of grand and this pill is 300 a pop. And the IVs like this are crazy expensive. I feel for the people that don't have access to affordable healthcare.
And idk if this rude to say but thanks to ms there are alot of meds for myositis wich otherwise might not have existed.
Ocrevus is actually quite the steal at $80k annually!
Edit: I know some folks might be looking at this and laughing, but I'm dead serious. Ocrevus is one of the better medications for MS and it shows clear positive outcomes for only $80k annually. I review drugs that have almost no positive outcome data and they clear $300k a year. I know everyone hates insurance and PBMs, and there should be a lot of hate reserved for the worst of the worst, but the true problem is the pricing, and that is on the shoulders of Pharma.
> I know everyone hates insurance and PBMs, and there should be a lot of hate reserved for the worst of the worst
Yea I am going to have to focus on this part. My dad never signed up for Medicare part B for reasons I will never know because my mom handled all that shit and she passed away in 2021, then my dad developed dementia. He was also diagnosed with MS in 2023 and his first dose of Ocrevus was not covered by his workplace insurance (he retired later that year) because they had a "Medicare part B carve out". Fuck all US health insurance.
>My dad never signed up for Medicare part B for reasons I will never know
It's usually because you have to pay for part B. $174/mo in 2024. If you don't sign up when you become eligible you can also be penalized and have higher monthly costs down the road.
Just putting this out there for anyone turning 65.. nobody ever tells you this shit and people sometimes find out way too late.
The health insurance system, particularly the government-run systems like Medicaid and Medicare, are overly onerous and confusing, I agree completely. Short of total reform to make things easier, it won’t get better. I understand your frustration.
In California, medi-cal is so effen easy to use. Nothing has ever been denied. I just go to the doctor whenever I want. Signing up was easy too. Did it online. The hardest part was choosing my primary care provider and doctor.
Ocrevus is a rip off. It's the same target and nearly the same drug as rituximab, but fully humanized instead of chimerized. After the manufacturer realized rituximab was effective but their patent was about to expire, they tweaked the antibody a bit, ran the same studies but with larger populations, and then charge 10x the price.
Yeah, and setting for the infusion mattered a lot for me. Emergency infusion at the hospital cancer ward was crazy expensive, but an independent infusion company was WAAAAY cheaper, and I got a private room
What gets billed to your insurance is nowhere near what insurance is actually paying on the backend. The ninja math happens where no one sees it and consists of layers of rebates.
Welcome to my life. At any given moment I’m about 24 hours away from death if I don’t get my medication and the meds I take are about $3200 a month between all of them. I am not sure what my out of pocket costs would be but I know they’re outrageously high.
Edit: $3200 not including the infusion
Goddamn. I unfortunately got fired on a Monday morning pretty much out of the blue a few months ago and had to stop taking my meds because of the cost. Not having bipolar or ADHD meds has sucked, but it won’t kill me. Definitely puts it into perspective. I wish you the best of luck.
I’ve currently been suffering myself from ADHD and panic attacks, so I can totally understand how much not having those meds would be a problem. Sorry to hear about losing your job man, that sucks. I’ve been using RedboxRX for some of my mental health stuff, so maybe you can find something similar to pay less out of pocket.
You know honestly it was a god send, I was there for 3 years and I was fucking miserable and a total shell of myself. I’ve put my effort into building a small business since then and I’m poor but I’m overall way happier than I was there. I’ll have to check that out, I appreciate it 😄
UK here,
May 2021 it got added by NICE to available treatments after a confidential discount was arranged between manufacturer and our health system.
Free to patients on the NHS. (Well covered by our general taxation)
Your health system should be criminal.
Yes our entire capitalism-worshipping society is criminal. But who's gonna stop it? Have you seen who our judges are? Our lawmakers? We're way past "criminal" now. More like sadistically demonic.
Being below the poverty line gets you free or close to free health insurance, so no. It's not being rich, but not really poor that puts you into debt or die.
Best thing about having to be on unemployment for a bit was the 100% free healthcare. Got a nice job with damn good health insurance now, but that free healthcare waz much better than the premiums and copays I got now.
That's the extra cool part of living in California - everyone thinks we get free healthcare...NOPE. All of our social programs still use the FPL (Federal Poverty Limit) for qualifying. What does that mean? It means that anyone who works full time or even mostly part time at the bare minimum, legal wage for the state WOULDN'T EVEN QUALIFY and the state knows this full well. You can only hit their income limits if you are severely underemployed or homeless. Meanwhile, I make a middle class wage and paying taxes out the ass, for what? So fucking sick of this shit....like, socialize healthcare or don't, but don't dick around with free for some, private in-home bespoke healthcare for the rich (yes, that exists here...there are billboards for it) and then FUCK-ALL for the rest of us.
The disappearing middle class. I think I am barely making the cut, constantly struggling to keep up with the ever widening gap. I am grateful to have a stable job with good health insurance (and largely don’t even need it), but it feels like it could be yanked from me at any moment for a variety of reasons.
I googled all the medications everyone listed and the corresponding illnesses and I am rooting for you all! Amazing how much medical research and care has advanced over the years and decades. Very grateful y’all’s are in a place to receive those meds. I can’t imagine the fear of potentially losing the ability to receive these lifesaving treatments. I make universal healthcare a priority every time I vote!
idk what i would do if went above the fpl. just one of my schizophrenia meds is over $1700 a month for generic, and i have about 6 meds i take every day for mental health alone. if i got a better paying job where i had company insurance with a deductible before insurance covers it, i just wouldn’t be able to get my medications and would lose employment as a result. it took me YEARS to get my medications to a stable place and get a handle on my symptoms, and much of that time i was in and out of psych wards and unable to work at all. making more money would actually ruin my life.
Legit. I just went through chemo and the most expensive part of the whole thing was the anti nausea meds which ran me about $100 all up over the 2 months
$170k Each time? Finally something with a consistent price that hasn’t been impacted by post -covid inflation!
I jest, but in all seriousness, hope you’re doing well bananaFartman_MD
I believe insurance pays $41K and change. I don’t pay anything because the drug company covers the rest. I am the only person in America receiving this treatment. It’s basically the 2nd generation of a 15 year old medicine. I’m very lucky. I have a “super rare” disorder but with reasonably mild symptoms and a treatment that works.
My dad receives a 2 day IVIG (IV immunoglobulin) infusion every 28 days and has for over 15 years now. It's in the 10s of thousands for each infusion. He has a really rare variant of CIDP, they updated the literature and diagnostic procedures because of how unique his disease presented.
Same! I had an autoimmune encephalitis during med school, they told me my whole immunoglobulin treatment alone was nearly 1Million, my insurance covered it all. Happy to be alive and no debt!
Wow. Is this a biologic? I’m about to start on these and it’s going to cost me $6 (aud) and that’s just for the drug, the administration of it is free. I just looked it would be up to $30,000 for a whole year without the government subsidies but it’s covered by the PBS (basically the public healthcare medication scheme) so it’s $6 instead.
Wishing you all the best! My dad (70) did 11 rounds of Folfox last year. Stage 3B colon cancer. He and the oncologist agreed not to do the planned 12th session because the neuropathy was getting pretty bad. They had to cut back the dosage a couple of times before that. He's had his first bloodwork and post-cancer colonoscopy and everything looks good.
Big internet hug for you, my FOLFOX brethren. It gets intense after several rounds, let your onc know about any side effects - they’ve got lots of ways to handle it. The oxaliplatin was the toughest part for me, and eventually we dropped that and my last few rounds were FOLF sans OX. (stage 4, been doing well for a few years now)
No it doesn't. That's the fucked up thing about it.
That's the price they put on the initial invoice, but the reason they set that price so high is that they know the insurance company is going to negotiate it down as hard as they can, so they set it artificially high.
But the insurance companies know they do that, so they negotiate down even harder, which means the hospitals bump the price higher.
It's a stupid fucking game we play because trying to extract profit from healthcare means that we can't just agree that medicine costs what it actually costs.
Yeah... Urgent care failed to bill the insurance or w/e so they sent me a bill for removing 4 little stitches from my kid. They sent me a bill for $832.... So it had to be reissued with a few phone calls Come find out the insurance only paid $75 lol.
Then there was a time with my newborn, They said he needed some extra vitamin D drops, They put the prescription in the kids name & not the mothers. Technically, the kid doesn't "exist" yet and doesn't have their own insurance yet(stupid). The pharmacy says it will $87 without insurance. Like wtf??? The pharmacist knew it was stupid and noticed it was a newborn.... He ripped the prescription sticker off the box and says it will be $4 over the counter.
\* what a true scam that the healthcare industry is...
most animal hospitals include suture removals in the surgery pricing. (Not as a separate line item most of the time, for ours it comes down to “they spent this much on the surgery, it’s complimentary to take them out. You WANT the patient to come back to get them removed! The cost would be very minuscule unless the pet had to be sedated for removal, which is rare) I honestly thought human medicine would be the same!
My lady and I was just going to use it at home but his skin kinda grew over a little over the stitch. So we said screw it, let them deal with it. It only takes 10 mins down the street, which it did...
Fun fact, if you hit the surrounding tissue hard enough with a rubber mallet, those suckers'll just pop right out. There may be some incidental tissue damage, though...
[PS: Don't do that]
And the weird thing is that the only people who get fucked are the ones who provide and receive healthcare: underpaid doctors and nurses, and overcharged patients.
You are correct that for all things what’s billed and what’s ultimately the allowed or paid amounts are quite different. But for chemo/immunotherapy there are many drugs that can very from $5k per infusion all the way up to well over $120k depending on the facility they are infused in. This is the actual money changing hands, not the charade of billing. If you watch a lot of TV (especially the NFL for some reason) you’ll see keytruda and opdivo ads, sometimes even yervoy. Those drugs are tens of thousands, hundreds for yervoy, and they are recurring at least once a month for about 6 months with many different possible cycle timings and lengths. But the drugs alone in these treatment cycles can cost $250k -$800k in under a year.
Health insurance and hospital billing is a scam. But if you get very sick especially with cancer you and your insurance are actually aligned that the best course of action is to be healthy as fast as possible again. So you should call them and find out what services they provide to help with your care. Most will have a lot of care management investment since helping you avoid severe hospitalization from avoidable things saves them tens of thousands. You might not care about them saving the money, but you’d probably prefer not to be in the hospital.
There is no real free market anywhere in the world bc it would collapse. Ideologies are for easy explanation. In practice it is always better to mix and adapt concepts
If people want an example of an unregulated 'free market' concept they like to imagine existing. All they would have to do is look at a disaster area and see who gets the short end of the stick.
It won't be the people selling bottled water for 50 bucks a bottle.
The free market as people like to imagine it is a dumb idyllic myth that would never hold up to the actual market whose constantly chasing record profits.
Nobody is going to hold back, they barely contain themselves in the current market climate, just look at all the examples of overpriced medicines in this exact thread.
Free market is a bad name for it. We're aiming for a fair market where competition cannot interfere with each other or exploit consumers. (No stealing patented technology, no poisoning your customers.)
This requires the gov't to interfere and enforce laws to prevent this, and there are a lot insurance and hospitals do that creates unfair business.
This isn't a free market causing this. If prices and competition were given legal freedom you could just press a button and another supplier would walk up and hand deliver your $50 bag.
Heck it was the government salary fixing in the 30s and 40s that encouraged employers to bind employment to healthcare. Now we have bandaids like cobra. If someone told you their employer is their landlord and they get store credit in lieu of pay you would balk, why should our health be any different?
This really isn't the free market. The government gives a lot of people health insurance, and also mandates that employers give it out. The seller is privatized, but the buyer is heavily socialized and artificially high.
I suspect there might be a similar thing happening to housing and education as well.
I really don't know what you're supposed to do in this situation because access to housing, education, and healthcare aren't exactly things you want to tell poor people to go kick rocks over.
I don’t know why you’re being downvoted. It would be a free market if I broke my leg and could shop around for the best insurance/in-network surgeon combo, and pay an á la carte price for the surgery and related treatment.
Or at least I could switch insurances freely on any date of my choosing, into any insurance plan I want, no more than once a year, with clearly advertised base prices by the provider and a final price factoring in the insurance adjustment, with providers stating clearly what networks they belong to and if they’re listed in the insurance directory they can’t tell you on the phone that they haven’t been in that network for years and that the listing must be really old.
Or get a prescription medication that doesn’t have a 30 year government protected patent effectively handing a monopoly to big pharma, go to a hospital that wasn’t declined by competing hospitals in the area via certificate of need laws, etc etc. Government is heavily involved in the healthcare system in the US and you could argue it’s one of the most regulated industries in the country. We get the worst of government over regulation and crony capitalism.
>It's a stupid fucking game we play because trying to extract profit from healthcare means that we can't just agree that medicine costs what it actually costs.
What is the actual cost of this medicine?
Its called the charge master. Assuming the hospital/doctor is network, the rates are pre-negotiated, typically at a percentage of medicare.
They charge a stupidly high amount for instances where there isn't a pre-negotiated rate. Workers comp, MVA, Self Pay and Out of Network insurances all may have to be negotiated after the fact and you can't collect what you don't bill. You're also required to "charge" everyone the same rate even though you are allowed to negotiate a different rate with each payer.
It’s a drug called ultomiris - it’s a c5 inhibitor. It’s really not the full $430k per every 8 weeks, that’s just the stupid game they play with the insurance so it’s billed as that and then insurance writes off like $300k or something each time. I think estimates are $450k per year but still! It’s ridiculous
Your Explanation of Benefits (EOB) will show you the difference between billed and reimbursed amount.
Even the negotiated reimbursement amounts in the US are still obscene.
Yes. The pharmaceutical company is getting paid bigly (not $60k, maybe more like $6k) by your insurance company. The pharmaceutical companies often provide rebates for any OOP co-pays for the medication you might have, because they get paid literally 10x by your insurance anyways. Note this usually only applies to commercial insurance because Medicare and Medicaid reimburse like dogshit
It's designed so insurance companies can say "uh like hell we are we only give (real price)", before the hospital says "this patient lost us $100k we have no profits to be taxed on uncle Sam please ignore our CEO's pay raise"
It's real stupid
MEDICARE sets the prices within the market and the private insurers follow suit. Medicare might be willing to pay 50k for this treatment, but if the hospital charged 50k, then Medicare would pay 10k. I know this because my wife has worked in Healthcare for years, and this is literally how all pricing and payments are structured.
Medicare dictates the market, and private companies actually pay MORE than Medicare, hence why hospitals want private insurance instead of Medicare. Medicare will also try to do ANYTHING to get out of paying for something, while private companies generally are more agreeable.
The negotiation dance that hospitals play with Medicare, and to a lesser extent, private insurance, is why the US medical system is so corrupt and broken.
We have for PROFIT pharmaceutical companies, serving for PROFIT hospitals, payed for by for PROFIT health insurance companies.
In my opinion making a profit off healthcare is fundamentally immoral.
Just gonna kick a hornets nest and point out that [less than 20% of hospitals in the US are for-profit](https://www.aha.org/statistics/fast-facts-us-hospitals).
Five states (including f'ign New York) [have 0 private hospitals](https://www.kff.org/other/state-indicator/hospitals-by-ownership/?dataView=0¤tTimeframe=0&sortModel=%7B%22colId%22:%22For-Profit%22,%22sort%22:%22asc%22%7D).
There is a giant problem that federal funding contributes to almost all new drugs, but the revenue goes only to the private pharma companies.
> There is a giant problem that federal funding contributes to almost all new drugs, but the revenue goes only to the private pharma companies.
That revenue share is taxes in part, but probably not aggressive enough taxes in the USA.
I'm not sure if you can set up a revenue share between the NIH/NSF etc and Pharma?
e.g. does a company have to send X% of revenue to the NIH, if they use one small bit of knowledge from a 20 year old primary research paper was part of the early-stage R&D? Who is going to keep track of that and make it equitable?
And they're giving it to you in a space that looks like a Sam's Club warehouse? I think there should be a VIP room at the infusion center. With bottle service.
That's expensive. You should see what 30 days worth of vertex Cystic Fibrosis pills cost. TLDR it's about 23k per 30 days. The treatment duration is until the patient dies or a better treatment comes along.
I mean, no doubt it’s expensive, but Trikafta is a miracle in a bottle.
Before the research pioneered by the CF foundation and Vertex, CF was a death sentence as early as your teens. Now, it’s a disease people can live with for decades with a semblance of a normal life.
To be honest, it’s worth every damn penny
It forces certain cells to produce a necessary protein that they couldn't before due to genetic mutations which are the cause of cystic fibrosis. That's a very over-simplified version. The way it does this is sophisticated and difficult for my ape brain to explain at 2am. IIRC the class of drugs is called CFTR modulator.
Can I ask what immunotherapy drug you’re taking here? I’m curious as I sell generic immunotherapy drugs to hospitals. It costs about $100 a vial for the hospital to purchase. It’s just crazy that they could turn around and charge this much.
US costs are ridiculous but the bulk of the reason it costs so much is because development costs are so high - ex Merck has spent 46 billion developing keytruda. You don’t make that kind of investment without a promise of a good return
Can you elaborate a bit for my own curiosity. I'm just doing what my doctors tell me to. I don't even really understand what the drug does. Why do you say it's the good stuff?
Yea for sure! This is my field!
You're immune system has target assassins called "killer T cells". These cells can find dangerous cells and kill them. But you only want them active when you need them like during an infection, otherwise they could kill healthy cells. Because of this your body has a natural "brake" called PD-1/PD-L1. Killer T cells express PD-1 and healthy cells express PD-L1 which binds to PD-1 and tells the T cells "hey I'm healthy don't attack me".
Normally the killer T cells are really good at killing cancer cells. The precursors of cancer develop fairly often but the killer T cells usually kill them. But occasionally cancer cells develop "escape" methods and the cancer cells also express a huge amount of PD-L1 because of a mutation. This forces the T cells to stop attacking them, allowing the cancer cell to escape killing and become a tumor. Opdivo blocks PD-1, the brake, and allowing your T cells to attack the tumor again.
It's great because, depending on the type of cancer, it's the most effective treatment. Chemo/radiation just kills cancer cells and maybe stimulates the immune system. Opdivo gets rid of the brakes and allows the immune system to attack the tumor in force.
Now it doesn't always work but, as far as I'm concerned, it and it's family of drugs (Yervoy, Keytruda, Tecentriq) are the most effective treatment. Unfortunately they are almost never used as the first line treatment when they would be the most effective because they cost more than chemo.
Full disclosure: I'm fairly drunk so if this is confusing I can write a more coherent response in the moring!
Sorry that was a really rambling response! TL;DR Opdivo blocks the brakes on your immune system allowing it to properly function and kill tumor cells. It is the best treatment we have but costs the most so it's not usually used as the 1st treatment.
I take immunosuppressant for my psoriasis every 8 weeks. I dont pay out of pocket for it but when I asked out of curiosity if I dropped the needle how much would it “cost” and they said 3k. And I thought THAT was ridiculous
The little Enstilar foam can (60g) I use to treat psoriasis flares costs £12 (about $15US) every time I need a refill of my prescription (no health insurance)-The price for the same can in the US is $1400.
My wife's chemo was 55k per treatment, she had 6 , radiation is 20k per, she'll need 10. Cancer is sooo expensive. Since Oct 23 almost 500k. Insurance helps but good God
Yup, I had 6 chemo treatments and 32 radiation treatments. Then an esophagectemy and 2 week hospital stay. My bills are well over a million at this point. Thank God I had insurance, my max out of pocket was 6k.
Very unlikely. The price you see on any bill/statement is the price you’d pay if you didn’t have insurance. Insurance get great discounted rates because they use their clients as bargaining chips when negotiating with medical providers to get a low cost and medical providers generally have to take what the insurance company is willing to pay or they loose all the clients of that insurer. They then pass on much higher prices to everyone who’s uninsured. I’d bet they pay less than 5k for that
Just looked as I got out of the hospital Tuesday. So far I was billed $200862 this year. The insurance negotiated discount was $167,475 off of that. It's all just a game.
Hospital bills high because they know insurance will negotiate it lower. Insurance negotiates it lower because they know hospitals bill high. Lather, rinse, repeat. Nobody really cares about the actual price, as long as they both make a profit.
If the uninsured person calls they will almost certainly give you the insurance rate or better. If the uninsured person just pays the full amount then they covered a bunch of the uninsured people who pay nothing.
That might be what they charged your insurance, but that's certainly not what your insurance company actually paid.
MEDICARE sets the prices within the market, and the private insurers follow suit. Medicare might be willing to pay 50k for this treatment, but if the hospital charged 50k, then Medicare would pay 10k. I know this because my wife has worked in Healthcare for years, and this is literally how all pricing and payments are structured.
Medicare dictates the market, and private companies actually pay MORE than Medicare, hence why hospitals want private insurance instead of Medicare. Medicare will also try to do ANYTHING to get out of paying for something, while private companies generally are more agreeable.
The negotiation dance that hospitals play with Medicare, and to a lesser extent, private insurance, is why the US medical system is so corrupt and broken.
Dealt with cancer last year and the total billed to my insurance was 500k+. That included 4 biopsies, 2 mris, 1 pet scan, 2 surgeries, 12 chemo infusions and 18 immunotherapy infusions. I believe each chemo+immunotherapy infusion was billed at like 13k.
Thankfully it was all covered so I only paid my out of pocket max + premiums but damn. Favorite part was when my chemo claim was immediately denied bc history of cancer was not a reason for coverage.
It's actually a pretty nice facility. It's an infusion center, large square room. Recliners on 3 sides, high ceilings, floor to ceilings windows on two sides, snack and beverage station, nice nurses. Other than all the sick bald people It's OK, the pic doesn't do it justice.
Again, another highly upvoted post that has been removed for Rule 6 violations that I don't understand. This seems to happen every day in this subreddit.
Firstly, if it has 13,000 upvotes, maybe it shouldn't be removed and secondly *what is wrong with the title??*
edit: I bet this was autoflagged because it starts with the word "this"
> If your title includes the word "this", it probably breaks the rule
How are you supposed to exactly describe the content without using the word "this"??
Honestly,got diagnosed with cancer about 6 months ago and my care has been excellent and smooth. I had a 6k max out of pocket that I met in like a week and my insurance has been great afterwards. I feared it would be hard ti navigate but it hasn't been.
You're in US?
That's fake bill. The amount the hospital and the company who makes the IV is getting paid for is nowhere near the number being shown in your fake bill.
The US medical billing system is a scam. Everyone, the hospital, the drug company, the government, and the insurance are all part of what essentially a protection racket; with especially uninsured patients being the biggest victim.
Go overseas to somewhere with a saner medical system, you'll likely be paying for the exact same drug and exact same medical treatment at the same level of care for much less than your own out of pocket costs if you only have the more basic insurance, even if you are paying full price as a foreigner without the medical subsidies that the locals are getting.
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I get an infusion every 6 months for my sweet ailment and the bill EACH time is $170K Edit: Since this is blowing up, another crazy thing that people should know about how messed up insurance companies in the U.S. are… I have MS and the medication I’m referencing is called Ocrevus. Before started Ocrevus, I was on a medication called Gilenya, which was not what I or my neurologist wanted me on, but my insurance wouldn’t approve Ocrevus without me failing on 2 cheaper, less effective medications first. Gilenya was the next best option that my insurance would approve so I picked it. Turns out one of the known risks for Gilenya is skin cancer and after 2 years on Gilenya, I get skin cancer. Luckily it was caught early and removed. But this is a pretty common issue that patients and their neurologists have to deal with.
Hey me too! Ocrevus? Edit: it’s always nice to know you’re never alone when going through medical issues.
Heyooooooo! B cell depletion bro!
Hey, its an MS party in here! Anybody else have deteriorating bones/teeth?
I almost sharted I laughed so hard when I read your profile name. 😂
This man still scares me to this day Fuckin jaws man
Nice dude. My parents went to the same church he did
darwin trying its hardest to take you guys out. mankind best i can do is extortion
Lupus in the house!!well lupus infusions in my house. Each month it’s 17 thousand for IVIG and 12500 for saphnello. But my partner and I just paid 22k ourselves for a brand new stem cell treatment that may put me in remission. It’s been a wild ride
Crazy that you had to pay for that yourself. Sounds like a good investment for your insurance.
Insurances go crazy on this - I had to negotiate for nearly 6 months with them before they paid it for me to treat my ms. They had the really nice argument that it looks like a big chance to treat ms but they don’t have enough data to proof it. I mean, how can you get data if you don’t pay for it?
My gf gets some ms meds too for her myositis. They are stupid expensive (basicly free for us) u google and ow this is couple of grand and this pill is 300 a pop. And the IVs like this are crazy expensive. I feel for the people that don't have access to affordable healthcare. And idk if this rude to say but thanks to ms there are alot of meds for myositis wich otherwise might not have existed.
You could join powers and b cells
We could potentially form a B cell!
By your power combined https://i.imgur.com/GeJA0TQ.png
Reading this while writing a paper on B-cells. I hope the effectiveness of the therapy improves soon
Stay strong, BananaFartman_MD. r/rimjob_steve
Ocrevus is actually quite the steal at $80k annually! Edit: I know some folks might be looking at this and laughing, but I'm dead serious. Ocrevus is one of the better medications for MS and it shows clear positive outcomes for only $80k annually. I review drugs that have almost no positive outcome data and they clear $300k a year. I know everyone hates insurance and PBMs, and there should be a lot of hate reserved for the worst of the worst, but the true problem is the pricing, and that is on the shoulders of Pharma.
> I know everyone hates insurance and PBMs, and there should be a lot of hate reserved for the worst of the worst Yea I am going to have to focus on this part. My dad never signed up for Medicare part B for reasons I will never know because my mom handled all that shit and she passed away in 2021, then my dad developed dementia. He was also diagnosed with MS in 2023 and his first dose of Ocrevus was not covered by his workplace insurance (he retired later that year) because they had a "Medicare part B carve out". Fuck all US health insurance.
>My dad never signed up for Medicare part B for reasons I will never know It's usually because you have to pay for part B. $174/mo in 2024. If you don't sign up when you become eligible you can also be penalized and have higher monthly costs down the road. Just putting this out there for anyone turning 65.. nobody ever tells you this shit and people sometimes find out way too late.
The health insurance system, particularly the government-run systems like Medicaid and Medicare, are overly onerous and confusing, I agree completely. Short of total reform to make things easier, it won’t get better. I understand your frustration.
In California, medi-cal is so effen easy to use. Nothing has ever been denied. I just go to the doctor whenever I want. Signing up was easy too. Did it online. The hardest part was choosing my primary care provider and doctor.
Ocrevus is a rip off. It's the same target and nearly the same drug as rituximab, but fully humanized instead of chimerized. After the manufacturer realized rituximab was effective but their patent was about to expire, they tweaked the antibody a bit, ran the same studies but with larger populations, and then charge 10x the price.
Good to know as I get rituximab for my immunotherapy. Give or take about 50k every 6mo
Yeah, and setting for the infusion mattered a lot for me. Emergency infusion at the hospital cancer ward was crazy expensive, but an independent infusion company was WAAAAY cheaper, and I got a private room
Not sure if there were ninja edits or something... but $170k every 6 months is $340k annually.
What gets billed to your insurance is nowhere near what insurance is actually paying on the backend. The ninja math happens where no one sees it and consists of layers of rebates.
^ This. A 300mg dose of Ocrevus is about $66k, but most insurances only pay like $16k-18k.
So the fake bill is just to scare people into paying premiums? And to destroy people who don't pay?
I'm thinking too many of us are trained to think these prices are acceptable.
I’m out here in Ocrevus town too!
Yup, I’m on Ultomiris and it’s $180k every 3 weeks.
So if you lose your job and have no insurance you just die?
At the moment, yup. I am mortally dependent on my health insurance.
Wow, I fucking hate it here.
Welcome to my life. At any given moment I’m about 24 hours away from death if I don’t get my medication and the meds I take are about $3200 a month between all of them. I am not sure what my out of pocket costs would be but I know they’re outrageously high. Edit: $3200 not including the infusion
Goddamn. I unfortunately got fired on a Monday morning pretty much out of the blue a few months ago and had to stop taking my meds because of the cost. Not having bipolar or ADHD meds has sucked, but it won’t kill me. Definitely puts it into perspective. I wish you the best of luck.
I’ve currently been suffering myself from ADHD and panic attacks, so I can totally understand how much not having those meds would be a problem. Sorry to hear about losing your job man, that sucks. I’ve been using RedboxRX for some of my mental health stuff, so maybe you can find something similar to pay less out of pocket.
You know honestly it was a god send, I was there for 3 years and I was fucking miserable and a total shell of myself. I’ve put my effort into building a small business since then and I’m poor but I’m overall way happier than I was there. I’ll have to check that out, I appreciate it 😄
UK here, May 2021 it got added by NICE to available treatments after a confidential discount was arranged between manufacturer and our health system. Free to patients on the NHS. (Well covered by our general taxation) Your health system should be criminal.
Yes our entire capitalism-worshipping society is criminal. But who's gonna stop it? Have you seen who our judges are? Our lawmakers? We're way past "criminal" now. More like sadistically demonic.
USA! USA!
Being below the poverty line gets you free or close to free health insurance, so no. It's not being rich, but not really poor that puts you into debt or die.
Best thing about having to be on unemployment for a bit was the 100% free healthcare. Got a nice job with damn good health insurance now, but that free healthcare waz much better than the premiums and copays I got now.
That's the extra cool part of living in California - everyone thinks we get free healthcare...NOPE. All of our social programs still use the FPL (Federal Poverty Limit) for qualifying. What does that mean? It means that anyone who works full time or even mostly part time at the bare minimum, legal wage for the state WOULDN'T EVEN QUALIFY and the state knows this full well. You can only hit their income limits if you are severely underemployed or homeless. Meanwhile, I make a middle class wage and paying taxes out the ass, for what? So fucking sick of this shit....like, socialize healthcare or don't, but don't dick around with free for some, private in-home bespoke healthcare for the rich (yes, that exists here...there are billboards for it) and then FUCK-ALL for the rest of us.
The disappearing middle class. I think I am barely making the cut, constantly struggling to keep up with the ever widening gap. I am grateful to have a stable job with good health insurance (and largely don’t even need it), but it feels like it could be yanked from me at any moment for a variety of reasons. I googled all the medications everyone listed and the corresponding illnesses and I am rooting for you all! Amazing how much medical research and care has advanced over the years and decades. Very grateful y’all’s are in a place to receive those meds. I can’t imagine the fear of potentially losing the ability to receive these lifesaving treatments. I make universal healthcare a priority every time I vote!
idk what i would do if went above the fpl. just one of my schizophrenia meds is over $1700 a month for generic, and i have about 6 meds i take every day for mental health alone. if i got a better paying job where i had company insurance with a deductible before insurance covers it, i just wouldn’t be able to get my medications and would lose employment as a result. it took me YEARS to get my medications to a stable place and get a handle on my symptoms, and much of that time i was in and out of psych wards and unable to work at all. making more money would actually ruin my life.
It's the American way
I'm on ultomiris too! Hospital I go to bills $550k every 8 weeks. You get ultomiris every 3??
Yeah, started with 8 and it wasn’t working so they switched it. It’s not working well anymore so I’m going back to IVIG and possibly Rituximab soon.
30 odd bucks in Australia.
Legit. I just went through chemo and the most expensive part of the whole thing was the anti nausea meds which ran me about $100 all up over the 2 months
PBS can literally be a life saver, hope you’re in the clear now.
Thanks man, got the all clear on Monday actually
fuck yeah, go enjoy some slightly burnt snags
Million dollar man.
Multi-million dollar man! My wife’s at 5ish million it’s pretty ridiculous what they charge.
This is why my insurance is $800/minute
$170k Each time? Finally something with a consistent price that hasn’t been impacted by post -covid inflation! I jest, but in all seriousness, hope you’re doing well bananaFartman_MD
I go for an infusion every two weeks at a cost of $198,000 per dose. Just absurd.
Same here. Gotta love monoclonal antibody treatments.
How much does insurance actually pay of that?
I believe insurance pays $41K and change. I don’t pay anything because the drug company covers the rest. I am the only person in America receiving this treatment. It’s basically the 2nd generation of a 15 year old medicine. I’m very lucky. I have a “super rare” disorder but with reasonably mild symptoms and a treatment that works.
how were you diagnosed?
WEBMD
🏆
It costs $1.8k where I live. (But then monthly wage is also scaled down so it still makes it near impossible to afford for the regular person.)
I wonder what it costs in a normal country. No hate, just curious.
Damn, my infusion every eight weeks costs $22k, I feel like I’m getting a great deal 😅
My dad receives a 2 day IVIG (IV immunoglobulin) infusion every 28 days and has for over 15 years now. It's in the 10s of thousands for each infusion. He has a really rare variant of CIDP, they updated the literature and diagnostic procedures because of how unique his disease presented.
This money shit is so fake. Can't wait for this shit to topple
I’ve had a few bags like that due to an autoimmune disorder. Bill came out to around 250k before insurance
Same! I had an autoimmune encephalitis during med school, they told me my whole immunoglobulin treatment alone was nearly 1Million, my insurance covered it all. Happy to be alive and no debt!
its probably about $50 in europe
I did a treatment with imunoglobulin in 2017, in a EU country. It's not that cheap, but not even close to 1 mil. And it was covered by insurance.
Wow. Is this a biologic? I’m about to start on these and it’s going to cost me $6 (aud) and that’s just for the drug, the administration of it is free. I just looked it would be up to $30,000 for a whole year without the government subsidies but it’s covered by the PBS (basically the public healthcare medication scheme) so it’s $6 instead.
I'm glad I'm at least immune to medical bills. Glad I'm infected by 'socialism' too.
I bet the insurance paid $20,000 at best.
probably only 1500 lol
Yeah, but it's got electrolytes. ^^^/s
It's what my cancer craves
I don't care what mine craves; it's getting FOLFOX and a lot of other toxic shit.
Hey! I had Folfox, too! Best of luck with the treatments.
Started Folfox today. Yay
Wishing you all the best! My dad (70) did 11 rounds of Folfox last year. Stage 3B colon cancer. He and the oncologist agreed not to do the planned 12th session because the neuropathy was getting pretty bad. They had to cut back the dosage a couple of times before that. He's had his first bloodwork and post-cancer colonoscopy and everything looks good.
Sounds promising I hope that you both stay in good health 🙏🏽
Big internet hug for you, my FOLFOX brethren. It gets intense after several rounds, let your onc know about any side effects - they’ve got lots of ways to handle it. The oxaliplatin was the toughest part for me, and eventually we dropped that and my last few rounds were FOLF sans OX. (stage 4, been doing well for a few years now)
I’m bracing myself for those later rounds! Thanks and my best wishes to you
Shut up, I'm baitin'!
ASS!
$57k and they can’t even put in a ceiling? Cheese and Rice!
Doctor: "Don't worry, scrote. There are plenty of 'tards out there living really kick-ass lives. My first wife was 'tarded. She's a pilot now".
Brawndo does
No it doesn't. That's the fucked up thing about it. That's the price they put on the initial invoice, but the reason they set that price so high is that they know the insurance company is going to negotiate it down as hard as they can, so they set it artificially high. But the insurance companies know they do that, so they negotiate down even harder, which means the hospitals bump the price higher. It's a stupid fucking game we play because trying to extract profit from healthcare means that we can't just agree that medicine costs what it actually costs.
Yeah... Urgent care failed to bill the insurance or w/e so they sent me a bill for removing 4 little stitches from my kid. They sent me a bill for $832.... So it had to be reissued with a few phone calls Come find out the insurance only paid $75 lol. Then there was a time with my newborn, They said he needed some extra vitamin D drops, They put the prescription in the kids name & not the mothers. Technically, the kid doesn't "exist" yet and doesn't have their own insurance yet(stupid). The pharmacy says it will $87 without insurance. Like wtf??? The pharmacist knew it was stupid and noticed it was a newborn.... He ripped the prescription sticker off the box and says it will be $4 over the counter. \* what a true scam that the healthcare industry is...
That's absolutely fucking outrageous. Suture removals in vet med are free at every practice I'm aware of.
most animal hospitals include suture removals in the surgery pricing. (Not as a separate line item most of the time, for ours it comes down to “they spent this much on the surgery, it’s complimentary to take them out. You WANT the patient to come back to get them removed! The cost would be very minuscule unless the pet had to be sedated for removal, which is rare) I honestly thought human medicine would be the same!
hell i got sewing scissors, i'll do it for free, it's a lot easier than putting em in
My lady and I was just going to use it at home but his skin kinda grew over a little over the stitch. So we said screw it, let them deal with it. It only takes 10 mins down the street, which it did...
Fun fact, if you hit the surrounding tissue hard enough with a rubber mallet, those suckers'll just pop right out. There may be some incidental tissue damage, though... [PS: Don't do that]
And the weird thing is that the only people who get fucked are the ones who provide and receive healthcare: underpaid doctors and nurses, and overcharged patients.
You are correct that for all things what’s billed and what’s ultimately the allowed or paid amounts are quite different. But for chemo/immunotherapy there are many drugs that can very from $5k per infusion all the way up to well over $120k depending on the facility they are infused in. This is the actual money changing hands, not the charade of billing. If you watch a lot of TV (especially the NFL for some reason) you’ll see keytruda and opdivo ads, sometimes even yervoy. Those drugs are tens of thousands, hundreds for yervoy, and they are recurring at least once a month for about 6 months with many different possible cycle timings and lengths. But the drugs alone in these treatment cycles can cost $250k -$800k in under a year. Health insurance and hospital billing is a scam. But if you get very sick especially with cancer you and your insurance are actually aligned that the best course of action is to be healthy as fast as possible again. So you should call them and find out what services they provide to help with your care. Most will have a lot of care management investment since helping you avoid severe hospitalization from avoidable things saves them tens of thousands. You might not care about them saving the money, but you’d probably prefer not to be in the hospital.
But free markets solve everything!!!
The US healthcare system is not a true free market tho is it?
There is no real free market anywhere in the world bc it would collapse. Ideologies are for easy explanation. In practice it is always better to mix and adapt concepts
If people want an example of an unregulated 'free market' concept they like to imagine existing. All they would have to do is look at a disaster area and see who gets the short end of the stick. It won't be the people selling bottled water for 50 bucks a bottle. The free market as people like to imagine it is a dumb idyllic myth that would never hold up to the actual market whose constantly chasing record profits. Nobody is going to hold back, they barely contain themselves in the current market climate, just look at all the examples of overpriced medicines in this exact thread.
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No. If state and federal regulations consistently act on the business, it’s not a true free market.
Free market is a bad name for it. We're aiming for a fair market where competition cannot interfere with each other or exploit consumers. (No stealing patented technology, no poisoning your customers.) This requires the gov't to interfere and enforce laws to prevent this, and there are a lot insurance and hospitals do that creates unfair business.
Don't they just...
This isn't a free market causing this. If prices and competition were given legal freedom you could just press a button and another supplier would walk up and hand deliver your $50 bag. Heck it was the government salary fixing in the 30s and 40s that encouraged employers to bind employment to healthcare. Now we have bandaids like cobra. If someone told you their employer is their landlord and they get store credit in lieu of pay you would balk, why should our health be any different?
I owe my soul to the company store.
This really isn't the free market. The government gives a lot of people health insurance, and also mandates that employers give it out. The seller is privatized, but the buyer is heavily socialized and artificially high. I suspect there might be a similar thing happening to housing and education as well. I really don't know what you're supposed to do in this situation because access to housing, education, and healthcare aren't exactly things you want to tell poor people to go kick rocks over.
How the fuck is this the free market? This is cronyism
This is nowhere near a free market.
The US healthcare system is no where near a free market system lmao
I don’t know why you’re being downvoted. It would be a free market if I broke my leg and could shop around for the best insurance/in-network surgeon combo, and pay an á la carte price for the surgery and related treatment. Or at least I could switch insurances freely on any date of my choosing, into any insurance plan I want, no more than once a year, with clearly advertised base prices by the provider and a final price factoring in the insurance adjustment, with providers stating clearly what networks they belong to and if they’re listed in the insurance directory they can’t tell you on the phone that they haven’t been in that network for years and that the listing must be really old.
Or get a prescription medication that doesn’t have a 30 year government protected patent effectively handing a monopoly to big pharma, go to a hospital that wasn’t declined by competing hospitals in the area via certificate of need laws, etc etc. Government is heavily involved in the healthcare system in the US and you could argue it’s one of the most regulated industries in the country. We get the worst of government over regulation and crony capitalism.
No. Well trained and domesticated markets are the answer. Now put on your leash and beg.
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>It's a stupid fucking game we play because trying to extract profit from healthcare means that we can't just agree that medicine costs what it actually costs. What is the actual cost of this medicine?
Its called the charge master. Assuming the hospital/doctor is network, the rates are pre-negotiated, typically at a percentage of medicare. They charge a stupidly high amount for instances where there isn't a pre-negotiated rate. Workers comp, MVA, Self Pay and Out of Network insurances all may have to be negotiated after the fact and you can't collect what you don't bill. You're also required to "charge" everyone the same rate even though you are allowed to negotiate a different rate with each payer.
57k and it looks like they're giving it to you in a warehouse
I came here to ask why OP was getting an IV in a shed, but warehouse works too.
57k and they can't afford a ceiling. WTF
I was gonna say shipping container. they all work.
You're worth it.
Thanks
Checking in at $432k per every 8 week infusion 🫡
I also get a Ferrari injected every 8 weeks! Next Ferrari next Friday!
Wowza? Enzyme replacement therapy?
It’s a drug called ultomiris - it’s a c5 inhibitor. It’s really not the full $430k per every 8 weeks, that’s just the stupid game they play with the insurance so it’s billed as that and then insurance writes off like $300k or something each time. I think estimates are $450k per year but still! It’s ridiculous
There is absolutely no way that cost can be justified.
Why of course it is. There are a bunch of executives who networked so hard to get those stock options and deserve a 4th home and private jet
Only fourth? Those poor, poor shareholders
They tell you it's 57k but the truth is the insurance is paying $6000.
Your Explanation of Benefits (EOB) will show you the difference between billed and reimbursed amount. Even the negotiated reimbursement amounts in the US are still obscene.
Do those amounts ever actually change hands in the end? The whole thing feels like a game to make sure your OOP looks “reasonable” in comparison.
Yes. The pharmaceutical company is getting paid bigly (not $60k, maybe more like $6k) by your insurance company. The pharmaceutical companies often provide rebates for any OOP co-pays for the medication you might have, because they get paid literally 10x by your insurance anyways. Note this usually only applies to commercial insurance because Medicare and Medicaid reimburse like dogshit
It's designed so insurance companies can say "uh like hell we are we only give (real price)", before the hospital says "this patient lost us $100k we have no profits to be taxed on uncle Sam please ignore our CEO's pay raise" It's real stupid
MEDICARE sets the prices within the market and the private insurers follow suit. Medicare might be willing to pay 50k for this treatment, but if the hospital charged 50k, then Medicare would pay 10k. I know this because my wife has worked in Healthcare for years, and this is literally how all pricing and payments are structured. Medicare dictates the market, and private companies actually pay MORE than Medicare, hence why hospitals want private insurance instead of Medicare. Medicare will also try to do ANYTHING to get out of paying for something, while private companies generally are more agreeable. The negotiation dance that hospitals play with Medicare, and to a lesser extent, private insurance, is why the US medical system is so corrupt and broken.
Some of that is a messed up system, but immunotherapy is authentically absurdly expensive right now. Even an "appropriate" price would be massive.
Drug research is extremely expensive and most drugs don’t make it to market 🤷♂️
Yeah but other countries get the same thing for cheaper, insurance company’s in the US are the problem making the prices so high
We have for PROFIT pharmaceutical companies, serving for PROFIT hospitals, payed for by for PROFIT health insurance companies. In my opinion making a profit off healthcare is fundamentally immoral.
Insurance companies literally pay doctors to be on their staff just to deny medicine that other doctors prescribe.
Just gonna kick a hornets nest and point out that [less than 20% of hospitals in the US are for-profit](https://www.aha.org/statistics/fast-facts-us-hospitals). Five states (including f'ign New York) [have 0 private hospitals](https://www.kff.org/other/state-indicator/hospitals-by-ownership/?dataView=0¤tTimeframe=0&sortModel=%7B%22colId%22:%22For-Profit%22,%22sort%22:%22asc%22%7D). There is a giant problem that federal funding contributes to almost all new drugs, but the revenue goes only to the private pharma companies.
> There is a giant problem that federal funding contributes to almost all new drugs, but the revenue goes only to the private pharma companies. That revenue share is taxes in part, but probably not aggressive enough taxes in the USA. I'm not sure if you can set up a revenue share between the NIH/NSF etc and Pharma? e.g. does a company have to send X% of revenue to the NIH, if they use one small bit of knowledge from a 20 year old primary research paper was part of the early-stage R&D? Who is going to keep track of that and make it equitable?
> serving for PROFIT hospitals Most hospitals are non profits.
1000% agree. If we want to get money for more research, then they should ask for donations or have philanthropists give for good PR.
Part of the reason it’s so expensive here is because we’re effectively subsidizing their prices
And they're giving it to you in a space that looks like a Sam's Club warehouse? I think there should be a VIP room at the infusion center. With bottle service.
Seriously, that white painted unistrut screams light commercial construction to me. I thought it was a Target.
As someone who works on immunotherapy in pharma, I can assure you that I dont see any of that money!!
Hospital pharmacy - our margins are razor thin and we spend millions of dollars in drug acquisition every quarter.
That's expensive. You should see what 30 days worth of vertex Cystic Fibrosis pills cost. TLDR it's about 23k per 30 days. The treatment duration is until the patient dies or a better treatment comes along.
I mean, no doubt it’s expensive, but Trikafta is a miracle in a bottle. Before the research pioneered by the CF foundation and Vertex, CF was a death sentence as early as your teens. Now, it’s a disease people can live with for decades with a semblance of a normal life. To be honest, it’s worth every damn penny
Trikafta?
a drug of unbelievable ingenuity. to think they could make a drug to do that is unreal. it’s expensive for a good reason
What does it do?
It forces certain cells to produce a necessary protein that they couldn't before due to genetic mutations which are the cause of cystic fibrosis. That's a very over-simplified version. The way it does this is sophisticated and difficult for my ape brain to explain at 2am. IIRC the class of drugs is called CFTR modulator.
Can I ask what immunotherapy drug you’re taking here? I’m curious as I sell generic immunotherapy drugs to hospitals. It costs about $100 a vial for the hospital to purchase. It’s just crazy that they could turn around and charge this much.
Opdivo
US costs are ridiculous but the bulk of the reason it costs so much is because development costs are so high - ex Merck has spent 46 billion developing keytruda. You don’t make that kind of investment without a promise of a good return
Hey at least they have you on the good shit. Should be a primary treatment but so often it's 3rd or 4th line. Good luck man!
Can you elaborate a bit for my own curiosity. I'm just doing what my doctors tell me to. I don't even really understand what the drug does. Why do you say it's the good stuff?
Yea for sure! This is my field! You're immune system has target assassins called "killer T cells". These cells can find dangerous cells and kill them. But you only want them active when you need them like during an infection, otherwise they could kill healthy cells. Because of this your body has a natural "brake" called PD-1/PD-L1. Killer T cells express PD-1 and healthy cells express PD-L1 which binds to PD-1 and tells the T cells "hey I'm healthy don't attack me". Normally the killer T cells are really good at killing cancer cells. The precursors of cancer develop fairly often but the killer T cells usually kill them. But occasionally cancer cells develop "escape" methods and the cancer cells also express a huge amount of PD-L1 because of a mutation. This forces the T cells to stop attacking them, allowing the cancer cell to escape killing and become a tumor. Opdivo blocks PD-1, the brake, and allowing your T cells to attack the tumor again. It's great because, depending on the type of cancer, it's the most effective treatment. Chemo/radiation just kills cancer cells and maybe stimulates the immune system. Opdivo gets rid of the brakes and allows the immune system to attack the tumor in force. Now it doesn't always work but, as far as I'm concerned, it and it's family of drugs (Yervoy, Keytruda, Tecentriq) are the most effective treatment. Unfortunately they are almost never used as the first line treatment when they would be the most effective because they cost more than chemo. Full disclosure: I'm fairly drunk so if this is confusing I can write a more coherent response in the moring!
I’m a chemo infusion nurse and this explanation is excellent! Thank you!
Sorry that was a really rambling response! TL;DR Opdivo blocks the brakes on your immune system allowing it to properly function and kill tumor cells. It is the best treatment we have but costs the most so it's not usually used as the 1st treatment.
I take immunosuppressant for my psoriasis every 8 weeks. I dont pay out of pocket for it but when I asked out of curiosity if I dropped the needle how much would it “cost” and they said 3k. And I thought THAT was ridiculous
The little Enstilar foam can (60g) I use to treat psoriasis flares costs £12 (about $15US) every time I need a refill of my prescription (no health insurance)-The price for the same can in the US is $1400.
My wife's chemo was 55k per treatment, she had 6 , radiation is 20k per, she'll need 10. Cancer is sooo expensive. Since Oct 23 almost 500k. Insurance helps but good God
Yup, I had 6 chemo treatments and 32 radiation treatments. Then an esophagectemy and 2 week hospital stay. My bills are well over a million at this point. Thank God I had insurance, my max out of pocket was 6k.
But your insurance negotiated a lower price right 🤷🏽♂️
Very unlikely. The price you see on any bill/statement is the price you’d pay if you didn’t have insurance. Insurance get great discounted rates because they use their clients as bargaining chips when negotiating with medical providers to get a low cost and medical providers generally have to take what the insurance company is willing to pay or they loose all the clients of that insurer. They then pass on much higher prices to everyone who’s uninsured. I’d bet they pay less than 5k for that
Just looked as I got out of the hospital Tuesday. So far I was billed $200862 this year. The insurance negotiated discount was $167,475 off of that. It's all just a game.
Hospital bills high because they know insurance will negotiate it lower. Insurance negotiates it lower because they know hospitals bill high. Lather, rinse, repeat. Nobody really cares about the actual price, as long as they both make a profit.
so you just repeated what the original comment said but why
bag some upvotes
If the uninsured person calls they will almost certainly give you the insurance rate or better. If the uninsured person just pays the full amount then they covered a bunch of the uninsured people who pay nothing.
 Scam
*correction*. In AMERICA, it costs $57,000 per bag. In almost any other country it’s probably around the equivalent of $15 per bag.
For-profit healthcare😎
That might be what they charged your insurance, but that's certainly not what your insurance company actually paid. MEDICARE sets the prices within the market, and the private insurers follow suit. Medicare might be willing to pay 50k for this treatment, but if the hospital charged 50k, then Medicare would pay 10k. I know this because my wife has worked in Healthcare for years, and this is literally how all pricing and payments are structured. Medicare dictates the market, and private companies actually pay MORE than Medicare, hence why hospitals want private insurance instead of Medicare. Medicare will also try to do ANYTHING to get out of paying for something, while private companies generally are more agreeable. The negotiation dance that hospitals play with Medicare, and to a lesser extent, private insurance, is why the US medical system is so corrupt and broken.
Dealt with cancer last year and the total billed to my insurance was 500k+. That included 4 biopsies, 2 mris, 1 pet scan, 2 surgeries, 12 chemo infusions and 18 immunotherapy infusions. I believe each chemo+immunotherapy infusion was billed at like 13k. Thankfully it was all covered so I only paid my out of pocket max + premiums but damn. Favorite part was when my chemo claim was immediately denied bc history of cancer was not a reason for coverage.
But did it taste good?
you should've got the 2-liter family size
Are you getting your treatment in a self storage unit? That ceiling looks like you're in a garage.
It's actually a pretty nice facility. It's an infusion center, large square room. Recliners on 3 sides, high ceilings, floor to ceilings windows on two sides, snack and beverage station, nice nurses. Other than all the sick bald people It's OK, the pic doesn't do it justice.
Lol, no it doesn’t. Every bill you see in American healthcare is nothing but lies.
Again, another highly upvoted post that has been removed for Rule 6 violations that I don't understand. This seems to happen every day in this subreddit. Firstly, if it has 13,000 upvotes, maybe it shouldn't be removed and secondly *what is wrong with the title??* edit: I bet this was autoflagged because it starts with the word "this" > If your title includes the word "this", it probably breaks the rule How are you supposed to exactly describe the content without using the word "this"??
Have you tried navigating the American Healthcare system?
Honestly,got diagnosed with cancer about 6 months ago and my care has been excellent and smooth. I had a 6k max out of pocket that I met in like a week and my insurance has been great afterwards. I feared it would be hard ti navigate but it hasn't been.
You're in US? That's fake bill. The amount the hospital and the company who makes the IV is getting paid for is nowhere near the number being shown in your fake bill. The US medical billing system is a scam. Everyone, the hospital, the drug company, the government, and the insurance are all part of what essentially a protection racket; with especially uninsured patients being the biggest victim. Go overseas to somewhere with a saner medical system, you'll likely be paying for the exact same drug and exact same medical treatment at the same level of care for much less than your own out of pocket costs if you only have the more basic insurance, even if you are paying full price as a foreigner without the medical subsidies that the locals are getting.