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Pegasus and Ribovarin Therapy

I am just about to start my therapy, been to the classes, and thought I was prepared for what was to come, until the pharmacist called yesterday and told me the prescription would be $700.00 a month for the next year.  I made sure we were talking about the same medicine, and he said he had double checked what Blue Cross & Blue Shield (Group 105) was paying.  My doctor nor any of the nurses, or instructors had indicated this treatment would be costing anywhere near that, after insurance.  Does this sound like a mistake.

Steven sends...
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Avatar universal
The retail one month cost for pegasus is about $1300 for 4 shots and about $1100 for the copegus pills per month.

Insurance copayments can range from about $20 per month and up. I started out paying about $40 per month until the last 6 months when it went up tp about $400 per month when my company change insurance carriers. I know others have even payed more> You need to talk with your insurance company.

You also need to consider the cost of other drugs you may need as you get into tx (treatment) such as anti deppresants, sleeping aids, and other very expensive drugs to keep up your white and red blood counts such as Procrit and Neupogin (spelling?)

Also each pharmacy can charge different prices. I know some charge about $1800 for pegasus so shop around.
Avatar universal
like you my copay was outrageous at first-but then i met my yearly out of pocket limit and now ins pays 100% you might want to check & see if there's an out of pocket limit on your policy-also something interesting i noticed-once i met my out of pocket limit and the pharmacy knew my ins was paying 100% they have double the cost of my meds-seems like price gouging to me
Avatar universal
It's sad to say, but if you didn't have Rx insurance, you could get it from the drug company free of charge. That's how I got my tx. I am on Medicare and it doesn't pay for Rx's. Check with your insurance and see if they will cut you a better deal than that.
Good luck. I was on Pegasys and Copegus for 48 weeks and I had to have Neupogen once. But the anti-depressants and vitamins were a strain on my pocketbook. Being on Soc. Sec., it got real dicey there at times. Now that I am off tx, I feel a lot better, tho I still have a horrendous rash. It will pass with time.
I hope you can find the help you need. Even tho you have ins. I would still contact Roche and see if they will help at all.
Good luck and SVR for everyone!
Avatar universal
I am on Peg-intron and Ribaviran (generic; Rebetol was the brand name).  Ins pays about $1300/mo for the Peg and $700/mo for the Riba (was $1250 on brand name).  Check your max out of pocket cost.  My ins covers 100% after my deductible of $600.
Another thought might be to wait til January and get all the meds in the same year to avoid further deductibles.

Good luck to you.
Avatar universal
Man, sorry to hear about the high price of tx..That sucks!! It is so ridiculous, the way things work out.. Here, you have insurance, work, pay taxes etc, and have to pay so much.. Now if you didn't work, didn't have insurance, you would get a free ride.. My mom is on SSI, and gets free health insurance.. Everything is covered, no copays or anything..She is about to start tx too, and has no copay..
The system sucks..

Hey, just wanted to add something that my Dr mentioned yesterday.. Once on tx, to throw away hairbrushes, toothbrushes, and razors, every month.. That you could reinfect yourself, via one of these..Makes alot of sense.. If you reach undetectable, then reinfect yourself with a razor or toothbrush, that would suck!!!
Just a little tip, don't know if anyone else was told this by their Dr, but thought it was worthy to pass along..
Avatar universal
Great heads up.  Thanks.
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