Re: How much does Xolair cost?

[Guest guest]

The maximum retail costs of 375mg every two weeks (the max dose) is

about $36,000. Most insurance plans contract with one of the five

specialty pharmacies that distribute Xolair to get a reduced rate, so

Xolair ends up costing $20,000-$30,000 a year for most patients, most

of which are covered by insurance, although co-payments vary greatly

by patient and plan. Doug has horrible co-payments; mine are

miniscule. I used to have no co-pay.

Xolair is not billed like a regular prescription, so looking at your

prescription plan will do you no good. Most insurances bill it

similarly to chemotherapy.

Addy

Group co-owner

Remember to discuss any changes in your treatment plan with your

doctor.

--- In , " blondy2061h " <blondy2061h@...>

wrote:

>

> I keep hearing how expensive it is. How expensive is it?

>

[Guest guest]

Welcome to the group, there is a lot of good information here.

I had Community Care (Oklahoma) and my co-pay was $45.00 for a three

month's supply. I have just retired and am now with Blue Cross (long

story) and my co-pay is $150.00 for a three month's supply. This

includes all the paraphernalia that goes with it, needles, syringes,

sterile water, etc. I self inject at home.

I fought to get on Xolair and will fight to stay on Xolair. I have no

side effects from Xolair, I've got a bunch from other meds I take,

but I will continue taking Xolair and have been convinced that

breathing is not an option.

Ron

On Sep 13, 2006, at 5:22 AM, pyle456 wrote:

> The maximum retail costs of 375mg every two weeks (the max dose) is

> about $36,000. Most insurance plans contract with one of the five

> specialty pharmacies that distribute Xolair to get a reduced rate, so

> Xolair ends up costing $20,000-$30,000 a year for most patients, most

> of which are covered by insurance, although co-payments vary greatly

> by patient and plan. Doug has horrible co-payments; mine are

> miniscule. I used to have no co-pay.

>

> Xolair is not billed like a regular prescription, so looking at your

> prescription plan will do you no good. Most insurances bill it

> similarly to chemotherapy.

>

> Addy

> Group co-owner

> Remember to discuss any changes in your treatment plan with your

> doctor.

>

>

> >

> > I keep hearing how expensive it is. How expensive is it?

> >

>

>

>

[Guest guest]

Welcome, Blondie, to the group. There is a wealth of information among this

group of people plus many, many years of experiences with asthma.

My regular allergist does not accept medicare for xolair, so if he had given

me the shots, my co-pay would have been $360 a month. He and his nurse worked

to get me in at an allergy research clinic where the doctor does accept

medicare/supplemental insurance, so now it costs me nothing, but I had to do a

little pursuing of what to do next. (I am not a part of any of the research

groups, but they treat me very well. The nurse calls the next day each time I

have the shot to check on me and make sure I have had no reaction such as a knot

on my arm or hives, etc., which only one of their patients has had, and that was

only after the first shot.)

SPOC is a place online that you might get some information about financial

help. It seems to be hard to get much financial help beyond what insurance

pays.

I haven't had enough shots yet to tell if it is going to help--but I'm not any

worse, either!

Adah

Carpenter <cowtrail@...> wrote:

Welcome to the group, there is a lot of good information here.

I had Community Care (Oklahoma) and my co-pay was $45.00 for a three

month's supply. I have just retired and am now with Blue Cross (long

story) and my co-pay is $150.00 for a three month's supply. This

includes all the paraphernalia that goes with it, needles, syringes,

sterile water, etc. I self inject at home.

I fought to get on Xolair and will fight to stay on Xolair. I have no

side effects from Xolair, I've got a bunch from other meds I take,

but I will continue taking Xolair and have been convinced that

breathing is not an option.

Ron

On Sep 13, 2006, at 5:22 AM, pyle456 wrote:

> The maximum retail costs of 375mg every two weeks (the max dose) is

> about $36,000. Most insurance plans contract with one of the five

> specialty pharmacies that distribute Xolair to get a reduced rate, so

> Xolair ends up costing $20,000-$30,000 a year for most patients, most

> of which are covered by insurance, although co-payments vary greatly

> by patient and plan. Doug has horrible co-payments; mine are

> miniscule. I used to have no co-pay.

>

> Xolair is not billed like a regular prescription, so looking at your

> prescription plan will do you no good. Most insurances bill it

> similarly to chemotherapy.

>

> Addy

> Group co-owner

> Remember to discuss any changes in your treatment plan with your

> doctor.

>

>

> >

> > I keep hearing how expensive it is. How expensive is it?

> >

>

>

>

[Guest guest]

You will need prior authorization. Your doctor will have to run your

IgE levels (simple blood test - won't take more than a week to

process) and then complete paperwork that is required by both

insurance companies AND the Xolair manufacturer.

Addy

--- In , " blondy2061h " <blondy2061h@...>

wrote:

>

> I have Medco, and they run their own specialty pharmacy. Their

> website said $50 for three months, but I bet I would need prior

> authorization. I've never had my IgE levels measured, they I do have

> a host of environmental allergies.

>

[Guest guest]

My Dr. stated that for Xolair authorization purposes, he was not as

concerned as to what I was allergic to, but he needed my IgE readings.

On Sep 13, 2006, at 8:47 AM, blondy2061h wrote:

> I have Medco, and they run their own specialty pharmacy. Their

> website said $50 for three months, but I bet I would need prior

> authorization. I've never had my IgE levels measured, they I do have

> a host of environmental allergies.

>

>

>

[Guest guest]

I am very interested to hear you are with Blue Cross and getting

Xolair to self inject at $150. I am filing a grievance with Blue Cross

(I just had to change - long story) in Oregon because they say

Genentech does not allow self injection and are charging me $460 for

one month's supply. They refuse to send it to my home and I have to go

to my doc's office and pick it up. I have been sucessfully self

injecting under another ins. co. for over a year.

I know that Blue Cross is different in each state, but I am curious

whether they are allowing you to self inject.

I am literally being priced out of the market. I can't afford $460 per

month, but my income is not low enough to fit into a drug assistance

program.

--Kitty

> > >

> > > I keep hearing how expensive it is. How expensive is it?

> > >

> >

> >

> >

>

>

>

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[Guest guest]

This is not a done deal yet! I started Blue Cross as my primary

9-1-06, prior to that they were my secondary and had to pick up 80%

of my co-pay, which of course they didn't mind because my co-pay was

only $45, I have been self injecting for approximately 1 1/2 years

under Community Care. The first shipment to my house is supposed to

be on 9-18-06. If you check caremark.com, the pharmacy for Blue

Cross, they list your cost for Xolair as $150 for a 3 month's supply.

It does appear that Blue Cross is different, depending on the area

you live in and/or your plan. It should be noted that my plan is from

California.

http://www.caremark.com

Ron

On Sep 13, 2006, at 1:23 PM, lurkitty117 wrote:

> I am very interested to hear you are with Blue Cross and getting

> Xolair to self inject at $150. I am filing a grievance with Blue Cross

> (I just had to change - long story) in Oregon because they say

> Genentech does not allow self injection and are charging me $460 for

> one month's supply. They refuse to send it to my home and I have to go

> to my doc's office and pick it up. I have been sucessfully self

> injecting under another ins. co. for over a year.

>

> I know that Blue Cross is different in each state, but I am curious

> whether they are allowing you to self inject.

>

> I am literally being priced out of the market. I can't afford $460 per

> month, but my income is not low enough to fit into a drug assistance

> program.

>

> --Kitty

>

>

> > > >

> > > > I keep hearing how expensive it is. How expensive is it?

> > > >

> > >

> > >

> > >

> >

> >

> >

> >

[Guest guest]

When I first started I was under a Blue Cross PPO at my work.

Xolair had just come out and there was no self-injection. However,

the billing at the doc's office (I go to a big conglomerate) didn't

have a structure to cover the costs of them administering the shots,

b/c the insurance company would not pay for that IN ADDITION to the

actual Xolair and supplies. So we started self-injections after the

first injection b/c I had no problem with it. I used to inject

myself with allergy shots until the insurance companies started

freaking out about that. When my insurance coverage changed to my

huband's (still Blue Cross, but it's the state employee plan), self-

injection was the only option.

I'm really lucky that I go to a doctor who gives a damn. The nurse

was telling me that they have an elderly lady with emphasyma who has

to take an injectible drug for that and her insurance won't cover

injections at the doc's office. But the lady has PARKINSON'S. Can

you imagine????? SO the doc's office is giving her her injections at

no charge b/c that's good medicine.

Take care all,

Addy

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