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What do you pay for Avastin?


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This has been bothering me for a while so I figure it's time to ask.

I have not received a bill from the hospital for any of my chemos (I need to look into that), I have only received the explanation of benefits statement from the insurance company. The good news is that everything has been covered 100%, but the bad news is that just the avastin is costing from $19,000-$20,000 a pop!!! At this rate I will blow through my maximum lifetime benefit of $1,000,000 within the next three years and then be left without insurance. I figure I should be so lucky if I'm still taking it in three years, as that would mean that it's still working, but what happens when the money runs out?

I am wondering if the rest of you taking avastin are seeing these $$ too, or if something is wrong here. I am going to contact the hospital this week as I feel that I should be getting bills, even if everything is covered by insurance and I don't owe anything.



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[TracyD] The good news is that everything has been covered 100%, but the bad news is that just the avastin is costing from $19,000-$20,000 a pop!!!

I wonder if that's what the insurance company is actually paying, or if the $20,000 is more for show than anything else. Back when I was on commercial health insurance, I noticed that the "amount charged" for a couple of simple outpatient ear surgeries was over $3,000 each, but insurance actually paid around $1,200 each time and my statement stated this was a negotiated amount that the hospital had agreed to accept as payment in full. I was never billed for anything.

I'm on Medicare now, and the "amount charged" for each of my avastin treatments is $10,080. A more meaningful figure is the "Medicare approved" amount of $6,825 which the provider, in taking "Medicare assignment," agrees to accept as full payment. Of that amount Medicare actually pays 80%, or $5,460, and Tricare for Life (I'm a military retiree) pays the remaining $1,365.

All these medical billing intricacies are way over my head. Aloha,


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We know how expensive Avastin (and Tarceva) are and consider ourselves very fortunate to be in a clinical trial where Genentech, which makes both drugs, is picking up the cost. The cost was a factor in deciding to go into the trial. Genentech have a link on their web site for patient assistance, so for anyone already maxed out on their insurance, or about to, it might be worthwhile to persue it.


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