Epogen

[Rip1]

I read a post regarding the effects, costs, etc. of epogen and cannot find it for a reply. I did some research on epogen. In our center we do use a product called Aranesp (darbepoetin alfa.) It is produced by Amgen, also the makers of epogen), but is effective longer thus requiring a lesser dose to accomplishing the same results. Yes, medicare/medicaid does not pay for either of these products when your hematocrit reaches 38 or above.

It has been shown that in some patients epogen or aranesp can cause fluctuations in BP - sometimes serious and unpredictable. High levels can also cause clotting in your access, or can cause thrombosis (blood clots) in other parts of your body as well - especially in your lower limbs. Some other possible side effects of these products may be infections, fevers, headaches, muscle aches or soreness, nausea, diarrhea, leg swelling, and/or chest pain. Heck, I have those at one time or another not taking either of these products, but it is a good idea to mention it to your doctor if you do just in case. Especially if they are persistent or exceptionally severe.

Hope this answers some questions for those interested.

[susie q]

We get Aranesp here in Ontario also..  no problems so far.. 

[hephziba]

I started on epo and then moved to arenesp, and now I am moving back to epo, arenesp stings more when I inject it, epo never stung

[Panda_9]

Are you on hemodialysis heph?

[hephziba]

I was on hemo for 9 months, and just switched 10 weeks ago to PD.   

[Panda_9]

Oh bugger, pity you cant inject it into the bags 

[goofynina]

Hey Heph,  how is PD working for you?  Unfortunately, it didnt work for me,  i guess i am a "high transporter" blah blah blaaaah,  they ordered the cycler for me and i am hoping that works. I cant believe how much pain i have been in since starting PD,  I have been going to the clinic to learn the cycler while they  remove some excess fluid that built up while i was attempting the PD,  and it is working pretty good (i guess)  i was just really looking forward to it cuz all the stuff i read was pretty much all positive, but oh well, cant say i didnt try,   you know that saying,   "The only regrets we have in life are the risks that we dont take"  well, i am living by that,  soooooo, i am going to risk drinking a Margarita, lol,  (no salt)  have to be a little good,  hope to hear from you soon,   ciao
 

[Gram2Twinz]

I'm curious about the current cost of Epogen and the dosage that Home Hemo patients are using. The reson I ask is that I recently asked our center for an itemized bill for supplies, etc. (that they sent to our insurance co.) for our first few weeks of home hemo (Nxstage) training. I was adminstering it to my hubby "subQ" 1 time per week- we reduced the dose from 19,000 to 10,000 on 11/06
This is what the bill lists, perhaps someone can "decipher"it for me:
EPOGEN>10,000   100 UT SQ2           11/02/07           Quantity: 210                   $2656.50
                                                       11/06/06           Quantity: 190                   $2403.50
                                                       11/30/07           Quantity: 100                   $1265.00
Prior to beginning dialysis: I was injecting 100ml of Aranesp SubQ 2 times per month for a grand total cost of $30.00- we have excellent Rx ins. coverage. When we began in center dialysis I asked if we could continue to use Aranesp at home-I still had 4 left. I was told no, when beginning in center dialysis, only epo is used. Duh, I hadn't done my research. Davita+Epo=profit. I insisted we use what we had at home then we would go with Epo. I insisted. They relented. For a while anyway. Now that I have this itemized bill in hand, and I see the extreme cost of this medication, I'm wondering what our options are.

So this is my question for all you well informed, extremely intelligent, helpful IHD members:  Are your costs comparable to this? I'm not talking about what the insurance reimbursement is, I'm only asking about the cost billed to insurance. What are our options? Any advice is extremely appreciated.

[paris]

Yes, that looks like my bills to the insurance company!  I thought the Epo shots were expensive (around 800.00) until they started giving me Arenesp and I saw figures in the $2000's!!  Thank goodness for my great insurance.  I don't pay any co-pay for my shots.  Wouldn't you love to know the actual  bottom line cost of the shot? 

[stauffenberg]

The difference between EPO and Aranesp is not just that the latter acts more slowly than the former.  There is also an important difference in clinical application, which is that while EPO is usually necessary to treat the severe anemia characteristic of patients with endstage renal failure and on dialysis, Aranesp is more appropriate for those with large residual function who are gradually declining toward endstage renal failure, or for those with a transplant who do still not make enough red blood cells.