Forums > Pregnancy IssuesPage 1 2 3 4by: P Pickle Pants

re: My medication costs $1000/week! [long]

posted 4th Jan
<blockquote><b>Quoting Amelia Margaret:</b>" So glad they are generously covering you. But holy cow! What is the difference between that progesterone and regular progesterone in oil? Mine costs $45 out of pocket for a two week vial.  "</blockquote>



I have no idea! And that's how much people were saying it'd be ---$100-150/mo.

Guess I'm just lucky that my ins and my location = crazy expensive progesterone!
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I'm due May 28th (a girl), have 1 child & 6 angel babies & live in California
posted 4th Jan
Quoting P Pickle Pants:" <blockquote><b>Quoting Amelia Margaret:</b>" So glad they are generously covering you. ... [snip!] ... people were saying it'd be ---$100-150/mo. Guess I'm just lucky that my ins and my location = crazy expensive progesterone!"

I really hope things go well for you in this pregnancy. I'm currently involved in my own battle between doctors who don't get it, getting adequate care, and getting my insurance to cover the things I need. It's a whole lot of headache.
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I have 4 angel babies & live in Tallahassee, Florida
posted 4th Jan
<blockquote><b>Quoting Amelia Margaret:</b>" I really hope things go well for you in this pregnancy. I'm currently involved in my own battle between ... [snip!] ... who don't get it, getting adequate care, and getting my insurance to cover the things I need. It's a whole lot of headache."</blockquote>

I've been fighting for years. I'm just glad I found a doc who fights WITH me instead of against me now! It has made a huge difference in my morale and has left me with a tiny shred if hope that I know I wouldn't have without him! It's amazing how much things change when you get the right guy in a white coat rooting for you!
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I'm due May 28th (a girl), have 1 child & 6 angel babies & live in California
posted 4th Jan
I seriously just bawled doe you... lol That is amazing!
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I have 6 kids & 1 angel baby & live in Colorado
posted 4th Jan
aw thats amazing!
im glad everything worked out.
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I have 2 kids & live in Duncanville, Texas
posted 4th Jan
So here's the short version of what happened with Makena and why it's so expensive. P17 in the past has been compounded by compounding pharmacies for years and years. It cost about $100 per vial ... which if i remember correctly is about a month or so worth of shots. With in the past 2 years, Makena got the FDA approval to exclusively produce the progesterone shots.

That's when Makena sortof took advantage of the situation and started charging 10x what it cost originally. If i remember correctly, it went from costing about $1000 per pregnancy to about 45,000 per pregnancy. Makena got a lot of people ...annoyed. They were basically ripping people off who had no choice but to use their product. They never actually had to do any of the normal testing since the product had been used successfully for years.

After that, there were protests. Dr's refused to prescribe Makena and the FDA changed their minds and started letting the compounding pharmacies to produce the shots again. So you *can* still get vials of the shots for $100, but not from Makena.

Because they got so much bad press, they actually declared bankruptcy for a while and they initiated this program where they can cover the cost of the shots if you make under a certain amount. I'm actually really surprised they're still around. There's a KV pharmacy hate group on fb that handled most of the protests.

Last pregnancy, my high risk dr told me flat out that she refused to deal with them at all and she gave me a prescription to go through another mail order pharmacy.
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I have 3 kids & 3 angel babies & live in Massachusetts
posted 5th Jan
Quoting Summerfrost:" So here's the short version of what happened with Makena and why it's so expensive. P17 in the past has ... [snip!] ... flat out that she refused to deal with them at all and she gave me a prescription to go through another mail order pharmacy. "

That makes total sense.

My doc thought the compounding pharmacy would take too long to get it to me (between insurance, them making it, and then shipping it), so he knew Makena would ship a sample out immediately for free and i'd have it within 48 hours. He said if I had any problems after the inital sample with affording the meds, Makena would make arrangements and if that still didn't work, we'd figure out something else (probably going through a compounding pharmacy like he had mentioned). So, I think he went with Makena to get me the meds faster to start and knew i'd get 5 weeks in sample (he deals with them a lot), so he knew he had time to figure out the other way if Makena Care couldn't make it affordable for me.

Sad that they're screwing people over, but they're giving me my meds, so I won't complain! All I care about is getting the meds to keep this baby baking!
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I'm due May 28th (a girl), have 1 child & 6 angel babies & live in California
posted 5th Jan
Quoting Legendary Bonnie Beaver:" That is AWESOME!"

I'm pretty happy. Although i feel better knowing why some people a year or two ago only paid a small copay and mine was NUTS. I always feel better when things make more sense  
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I'm due May 28th (a girl), have 1 child & 6 angel babies & live in California
posted 5th Jan
Quoting Little momma09:" I'm on tricare prime as well and that makes me worry my p17 shots will cost a arm and a leg too =/ ... [snip!] ... up so darn much.... im gonna try to find my papers from the last shots i got and see if theyre still selling at the same price."
I'm interested to know this answer!
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I'm due May 28th (a girl), have 1 child & 6 angel babies & live in California
posted 5th Jan
Mine for 8 weeks were $24. Im on tricare prime as well. I went through a local compounding pharmacy not Makena. It was shipped next day with 8 vials, syringes, etc. Unfortunately, at 32/33 weeks, contractions have started and my ffn came back positive.
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I have 4 kids & live in Vicenza, Italy
posted 5th Jan
<blockquote><b>Quoting ♥Jada:</b>" Mine for 8 weeks were $24. Im on tricare prime as well. I went through a local compounding pharmacy not ... [snip!] ... next day with 8 vials, syringes, etc. Unfortunately, at 32/33 weeks, contractions have started and my ffn came back positive."</blockquote>


Oh, and I got it less than 24 hours after having it requested via the mail. Would have been same day if I'd have drove to get it.
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I have 4 kids & live in Vicenza, Italy
posted 5th Jan
Quoting ♥Jada:" Mine for 8 weeks were $24. Im on tricare prime as well. I went through a local compounding pharmacy not ... [snip!] ... next day with 8 vials, syringes, etc. Unfortunately, at 32/33 weeks, contractions have started and my ffn came back positive."

I'm on tri care standard, not prime. It took them a week to approve it. took them 2 weeks to approve my cerclage surgery. I know some people get approved faster, but they take FOREVER here.

And the compouding pharmacy told my doc they could ship 24-48 hours after receiving the order approved by insurance (which took a week).

So, I'm glad I didn't have to wait.

SORRY your FFN came back positive. Hopefully baby stays put a little bit longer. 33 weekers still have a VERY good survival rate and most live normal lives after just a little bit of TLC, so I'll be thinking good thoughts for you and hoping for the best.
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I'm due May 28th (a girl), have 1 child & 6 angel babies & live in California
posted 5th Jan
Quoting Summerfrost:" So here's the short version of what happened with Makena and why it's so expensive. P17 in the past has ... [snip!] ... flat out that she refused to deal with them at all and she gave me a prescription to go through another mail order pharmacy. "

I had completely forgotten about that! I remember hearing about it when they first jacked the price up and freaking out but then read about it and was relieved that it wasn't the kind of progesterone I was using. Thank you for the reminder as I will likely need the P17 for my next pregnancy.
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I have 4 angel babies & live in Tallahassee, Florida
posted 5th Jan
Quoting P Pickle Pants:" I'm on tri care standard, not prime. It took them a week to approve it. took them 2 weeks to approve ... [snip!] ... and most live normal lives after just a little bit of TLC, so I'll be thinking good thoughts for you and hoping for the best."

Did you have to be pregnant already for them to begin the process of approving your cerclage? What kind of cerclage do you have?
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I have 4 angel babies & live in Tallahassee, Florida
posted 5th Jan
<blockquote><b>Quoting Amelia Margaret:</b>" Did you have to be pregnant already for them to begin the process of approving your cerclage? What kind of cerclage do you have?"</blockquote>

Yeah, I have known I'd be getting one from the start, but they won't approve it til I'm pregnant. My doc ordered it at 14w and it wa approved at 16w and done at 17w.
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I'm due May 28th (a girl), have 1 child & 6 angel babies & live in California
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