Rough cost of various fertility drugs without insurance?

[Anonymous]

We're anticipating losing our insurance coverage for fertility drugs as of January 1st when BCBS changes its policy and, for a variety of reasons, switching insurance companies just isn't an option right now.

Does anyone know how much progesterone in oil costs when you're self-pay? How about delestrogen? I'm expecting that we'll need both for our upcoming FET.

Thanks so much

[Anonymous]

Check the language for the new policy, as the drugs you mention may be covered since they are also used for menopause. I ran out of IVF coverage for meds after my first IVF cycle and still get coverage for estrace, PIO, prometrium, and lupron with a small co-pay. I can also suggest going ahead and ordering your meds now while you still have coverage for sure. I am contemplating a DE cycle and will be asking about ordering meds now, since my co-pays are going up significantly next year.

[Anonymous]

They're covered, but only with prior authorization certifying that they will not be used in conjunction with an ART cycle. Women over 50 don't require prior auth, but that's not me. I'm going to try and get what I can filled in December before the coverage ends, but I suspect I won't be able to get everything I need this way (even if my doctor's office agrees to write the scripts early, which they may not).

[Anonymous]

PP here. There is no reason your doc can't or shouldn't go ahead and write the scripts for all that you need. Just let them know what is happening with your insurance. I am sure all of the REs are going to get bombarded - lol! I can say that I just filled a script for 3 vials of PIO and my insurance negotiated price was $90 for the prescription, though I paid $5.

Also, try calling Ambulatory Care pharmacy in Rockville (the one in the SG office building) and ask them what the price is for your drugs based on your insurance changes. They are super nice and can probably tell you whether you will still get the BCBS price next year even if they are not providing you the coverage that they once did. The insurance negotiated rate should be cheaper than the straight up out of pocket price.

[Anonymous]

The costs really vary - by hundreds of dollars for some drugs - pharmacy to pharmacy. Pharmacies that do a large volume of business with a certain drug get better deals from the drug companies and can offer that particular drug for less. It really pays to call the major on-line fertility pharmacies (Alexanders, Freedom - I don't recall them all right now) and check on pricing plus any shipping costs.

[Anonymous]

The PIO and delestrogen may not be covered initially because they are part of a fertility treatment but if you get pregnant you can likely get them covered as being associated with the pregnancy.

I also ended up using crinone suppositories rather than PIO and these should be covered since it's not an injectable.

But these two drugs are not the really expensive ones so it's probably not that big a deal. The FSH stims are the really pricey drugs and of course you don't need those for a FET.

[Anonymous]

PIO is much cheaper than endometrium. so is lupron compared to gonol f, etc.

[Anonymous]

I really don't want to derail this, but can you clarify whether the BCBS you're talking about is the FEP plan for feds, or a private company BCBS plan? TIA.

[Anonymous]

OP here -- thanks for all the feedback. I knew PIO, delestrogen, etc. were cheaper than Follistim. Just trying to get a sense of whether we're talking about $50 per refill or $250.

21:19 -- to answer your question, I'm referring to the FEP BCBS plan.

[Anonymous]

Anonymous wrote:OP here -- thanks for all the feedback. I knew PIO, delestrogen, etc. were cheaper than Follistim. Just trying to get a sense of whether we're talking about $50 per refill or $250.

21:19 -- to answer your question, I'm referring to the FEP BCBS plan.

Freedom Pharmacy has their self pay price list posted on their website if I remember correctly.

[Anonymous]

Here's a price list from one of the online fertility pharmacies....they don't look too expensive....

http://www.fertilitymeds.com/price-quotes.html

[Anonymous]

Anonymous wrote:We're anticipating losing our insurance coverage for fertility drugs as of January 1st when BCBS changes its policy and, for a variety of reasons, switching insurance companies just isn't an option right now.

Does anyone know how much progesterone in oil costs when you're self-pay? How about delestrogen? I'm expecting that we'll need both for our upcoming FET.

Thanks so much

I am currently selling a bottle on ebay. followig unsuccessful IVF treatment.

[Anonymous]

We had to pay out of pocket and we paid 4,000. Since I responded well my dowager was decreased an our pharmacy let us return the unopened medicine saving us 1,000. Try to find a pharmacy that will aloe you to return items also some might give you a different price if you pay up front since they don't have to wait for thebinsurance to reimburse.

[Anonymous]

Sorry our progesterone oil was about 80 dollars a vial. It was the cheapest of all the meds we had to purchase for ivf. A vial lasted us about 10 days.

[Anonymous]

Check Freedom Pharmacy (online). Their prices are pretty reasonable for out of pocket. You can also save more if you join Go direct or if your doc is part of their Heart program or something like that.