Epogen

[Jean]

Those with Mediacare as primary, EPO costs about $10.00 per 1,000 units.

Zach, does that include non-dialysis patients?

[Zach]

Those with Mediacare as primary, EPO costs about $10.00 per 1,000 units.

Zach, does that include non-dialysis patients?

I don't think so. Just those on dialysis.
Sorry.

[del]

My husband was only on epo for a little while just before PD stopped working and just after he started hemo.  If memory serves me right at that time each shot was about $70 Canadian. We were billed for it at the time because it wasn't covered by our insurance or MCP but we were told not to pay for it because it was in the process of going to be covered.  That was 13 years ago so I am sure the price has gone up since.  He is lucky his hemoglobin is always in the normal range and sometimes a little above. 

[billybags]

Zach you are the only one I know who has heard of mercea, no one else seems to have heard of it.  I do not know how much it costs but I know my husband prefers epo once a week.

[Zach]

Zach you are the only one I know who has heard of mercea, no one else seems to have heard of it.  I do not know how much it costs but I know my husband prefers epo once a week.

I may be incorrect, so perhaps you can ask you husband's doctor.

[hurlock1]

A "round" of Epogen of 21 days is $14700.00

Where did you get that figure from? That doesn't sound right. Unless you mean for an entire dialysis unit. My figure was per person.

21 days times $700.00 = $ $14700.00

[Rerun]

WE can refuse it.  Say you don't want Epogen.  I will if you will.  Let's make a list of people who will go into dialysis and REFUSE the damn expensive drug.  YOU CAN LIVE WITHOUT EPOGEN!  You may need a blood transfusion now and then but that can be donated by a friend or family member for less money.  Hope you don't want a transplant though because blood transfusions just add to your antigens.

I will be first!   NO EPOGEN!

[Zach]

A "round" of Epogen of 21 days is $14700.00

What is you hemoglobin?  And what is the dose per treatment you receive?

EPO costs your dialysis center about $10.00 per 1,000 units.

If you or your private insurance company is being charged more, than it is your dialysis facility that is part of the problem.

[calypso]

A "round" of Epogen of 21 days is $14700.00

Where did you get that figure from? That doesn't sound right. Unless you mean for an entire dialysis unit. My figure was per person.

21 days times $700.00 = $ $14700.00

You take vanco 4 times a day for 21 days, you take EPO or Aranesp once every 1 or 2 weeks. $14,700 would be for 21 doses, not days! I was talking about time frame versus money spent, seeing as time is money.

Oops I assumed my Aranesp dosage of once every 2 weeks when I was on PD, clearly everyone gets a different dose depending on individual characteristics and modality of dialysis. Which reminds me of an article I read about how hemo clinics purposefully administer more aranesp to maximize profits: http://www.boston.com/business/healthcare/articles/2006/10/24/some_see_profiteering_in_clinics_use_of_drug/

[Zach]

 Which reminds me of an article I read about how hemo clinics purposefully administer more aranesp to maximize profits: http://www.boston.com/business/healthcare/articles/2006/10/24/some_see_profiteering_in_clinics_use_of_drug/

Good research, calypso!

[sico]

I was having 40mcg of Aranesp weekly administered in the lines when i was on HD.
Now on PD i have 20mcg every 12 days. I was told that on HD you lose more blood cells through the dializer.

[Lillupie]

EPO, has actually been out since the early 1990s. Yes it is expensive. THey have told me once my hemoglobin levels go above 12 I cant have anymore EPO. THey claim that hemoglobin levels higher then 12 you are at risk for a seizure. But what I rreally think it is, they dont want to pay for it (medicare)
 Before EPO, you got a blood transfusion. I do know of a guy who has been on dialysis since 1968. Every time his hemoglobin or hemocrit dropped below a certain number, he had a blood transfusion. Which causes a lot of antibodies, he has no chance of getting a transplant because he is 100% desentized.

Lisa

[Lillupie]

DONT YOU DARE> I got kicked off the transplant list once because I refused the Aransep!
They said they had to put me on hold for the transplant list because they wanted to make sure I was going to take my medicine.
 
I am trying to tell people dont refuse nothing! I am going to state this in my book too. 
Lisa

WE can refuse it.  Say you don't want Epogen.  I will if you will.  Let's make a list of people who will go into dialysis and REFUSE the damn expensive drug.  YOU CAN LIVE WITHOUT EPOGEN!  You may need a blood transfusion now and then but that can be donated by a friend or family member for less money.  Hope you don't want a transplant though because blood transfusions just add to your antigens.

I will be first!   NO EPOGEN!

[sico]

Good advice Lisa, the Doc prescribes our medication for a good reason.
If you refuse meds now they think you could do the same with the immune suppressants.

DONT YOU DARE> I got kicked off the transplant list once because I refused the Aransep!
They said they had to put me on hold for the transplant list because they wanted to make sure I was going to take my medicine.
 
I am trying to tell people dont refuse nothing! I am going to state this in my book too. 
Lisa

[Rerun]

I was not saying to refuse a life saving transplant drug.  I was stating that if you want the price of Epogen to go down or anything for that matter (Gasoline) you boycott it.  You can live without Epogen.  I did for years. 

Having said that..... the transplant team is forcing you to take Epogen....  "Thank You" From: Amgen $$$$$

                                                               

[cariad]

DONT YOU DARE> I got kicked off the transplant list once because I refused the Aransep!
They said they had to put me on hold for the transplant list because they wanted to make sure I was going to take my medicine.
 
I am trying to tell people dont refuse nothing! I am going to state this in my book too. 
Lisa

No, no, no, Lisa! With respect, I could not disagree with this advice more. Rerun is right, they are forcing you to take a drug that you stated, for whatever reason, you did not want. Patients rights are crystal clear on this issue. (You are in the US, right?) Patients have a right to refuse any treatment or any part of any treatment without their care being compromised.

There is, however, an effective and an ineffective way to refuse treatment. I suspect they were taking advantage of the fact that you are young and female and perhaps did not have a history of standing up for yourself? With any new drug, I insist on first being given the option to do my own research and consult a doctor whom I trust. Aranesp was introduced in 2005, and there have certainly been issues - issues like kidney patients dying in greater numbers when their hemoglobin gets above a certain number and the drug is still being administered. I take Aranesp because it works for me. I hate getting the shot (ouch!) and the price is ridiculous, but I do need it.

DO NOT let these doctors convince you that they are gods, infallible, or that they always have some mysterious, doctor-ey reason for something that you could not possibly understand because you don't have some fancy degree. Ask questions, demand answers. Change nephrologists, dialysis centers, or transplant centers if they are going to play list games with you. I could go on and on, but I would be saying the same thing a hundred different ways: do not let yourself be bullied into treatment.

On a related topic, I was under the impression that new state laws ban most gifts and kickbacks from pharmaceutical companies to doctors (in certain states). I have also heard that there is a way to look up what your doctor is receiving from these companies? If anyone has a link, I would love to see it. I have searched for a way to look for my state and found nothing.

[nursewratchet]

Medicare has very strict antikickback laws.  I will look for the link.  We (MD's and nurses) have to take an inservice and a test every year. 

[Malibu]

If you were to purchase the Epogen at Sam's Club it would only cost about $400 depending on the dosage.

At our clinic it is $2000 a dose.....for people with traditional insurance.  I don't know what it is for people on medicare but I will in about a month!!! 

[Swee_tone]

EPO, has actually been out since the early 1990s. Yes it is expensive. THey have told me once my hemoglobin levels go above 12 I cant have anymore EPO. THey claim that hemoglobin levels higher then 12 you are at risk for a seizure. But what I rreally think it is, they dont want to pay for it (medicare)
 Before EPO, you got a blood transfusion. I do know of a guy who has been on dialysis since 1968. Every time his hemoglobin or hemocrit dropped below a certain number, he had a blood transfusion. Which causes a lot of antibodies, he has no chance of getting a transplant because he is 100% desentized.

Lisa

Taken from Wikipedia:

"Darbepoetin alfa (rINN) (pronounced /dɑrbəˈpɔɪtɨn/) is a synthetic form of erythropoietin. It stimulates erythropoiesis (increases red blood cell levels) and is used to treat anemia, commonly associated with chronic renal failure and cancer chemotherapy. Darbepoetin is marketed by Amgen under the trade name Aranesp."
"Like EPO, its use increases the risk of cardiovascular problems, including cardiac arrest, arrhythmia, hypertension and hypertensive encephalopathy, congestive heart failure, vascular thrombosis or ischemia, myocardial infarction and edema. Also seizures and strokes. "
"Other reported adverse reactions include hypotension, fever, chest pains, nausea and myalgia"

"Erythropoietin is associated with an increased risk of adverse cardiovascular complications in patients with kidney disease if it is used to increase hemoglobin levels above 13.0 g/dl.[23"

I'd still use it though. As much as safely possible and amounts recommended by the doctor.

[sico]

"Erythropoietin is associated with an increased risk of adverse cardiovascular complications in patients with kidney disease if it is used to increase hemoglobin levels above 13.0 g/dl.[23"

I'd still use it though.

My hemoglobin went close to 150, and i was taken off it for three months. then when i had bloods done it was around 80. 

[Lillupie]

THat may be you. You might be ok without EPO. Usually we dialysis patients need EPO to make red blood cells, without it we will become anemic.
Yes you are right we can boycott and refuse EPO, but at the same time the transplant team has a right to refuse you a kidney. They think if you are not going to do what you are told to do on dialysis, when you wont take a bunch of pills.

Lisa

I was not saying to refuse a life saving transplant drug.  I was stating that if you want the price of Epogen to go down or anything for that matter (Gasoline) you boycott it.  You can live without Epogen.  I did for years. 

Having said that..... the transplant team is forcing you to take Epogen....  "Thank You" From: Amgen $$$$$

                                                               

[okarol]

THat may be you. You might be ok without EPO. Usually we dialysis patients need EPO to make red blood cells, without it we will become anemic.
Yes you are right we can boycott and refuse EPO, but at the same time the transplant team has a right to refuse you a kidney. They think if you are not going to do what you are told to do on dialysis, when you wont take a bunch of pills.

Lisa

I was not saying to refuse a life saving transplant drug.  I was stating that if you want the price of Epogen to go down or anything for that matter (Gasoline) you boycott it.  You can live without Epogen.  I did for years. 

Having said that..... the transplant team is forcing you to take Epogen....  "Thank You" From: Amgen $$$$$

                                                               

A good transplant team will not see a patient as non-compliant for something like refusing Epogen. And any dialysis clinic who makes a claim like that in a patient's file are opening themselves to a lawsuit by the patient, so it seems unlikely that it could happen. More is being revealed about the Epogen drug pushers and it's probably going to affect how the Epogen is distributed. http://ihatedialysis.com/forum/index.php?topic=16845.0

[dwcrawford]

Isn't it wonderful that we live in a country where, now at least, we can make our own determination about whether to accept or reject drugs, and at the same time, bear the responsibility for our decisions?

In the meantime, I've been following this thread hoping I could learn more about epogen.  My hemoglobin  is  too high, Nephrologist asked about epogen and I've never been on it.  Next week I am  scheduled for a Cat Scan to look for  some king of possible cyst on my kidney.  It is a little scary but at the same time I trust my doctors and want to hurry and get this over with.  Just wondering if anyone could shed any insight into the possible repercussion of too high hemoglobin and and will it be a simply matter. 

[willowtreewren]

Dan,
In another thread I read tha too high Hgb can make the blood "sticky" leading to clots and adverse effects on the heart.

Today Carl's Hbg was 12.4, the cut off at our clinic for administering Epogen. I'll be giving him small dose (.15 units) weekly until his next labs in January. He has not needed it for many months. He also gets Venifer (iron) by IV when we go to the clinic every month.

Aleta

[dwcrawford]

My labs this time showed 15.4.  It is the first out of range marker I've received other than low phosphorous and low protein.  This is obviously why the doctor asked me to come in to check for possible reasons.....  I guess.  Unless he just wants to take me to lunch or somehing (LOL).

There is something seriously wrong with a person who always HAS to end a comment with some stupid... I need to locate that "self esteem" thread again.