Saturday, March 12, 2011

What A Headache...

I recently found out that the medication (hydroxyprogesterone caproate aka 17P injections) that I've been on this entire pregnancy will soon skyrocket in price and be nearly too expensive to obtain. Wonderful! Until now, it was covered by our insurance and only cost me a small copay plus shipping so it was no big deal. However, things will soon change as I know our insurance company and a couple of others are not picking this drug up under their coverage. I hope that changes quickly, but if not, that means that my $14/vile expense would jump to $7500/vile. (One vile lasts about a month.) Can you imagine? This insane hike in price is going to result in so many women going without, even though they need it. For a drug with such a detrimental effect -- preventing preterm labor -- it sucks to see a company monopolize on it like they are.

All that to say that I spent my entire morning yesterday on the phone with three different specialty pharmacies, my insurance company, the company that covers my prescription benefits, and the company that is in charge of producing the new form of this drug -- hours on end going back and forth just trying to get answers. Initially, no one knew if this would be covered under our insurance, but by the end, I finally found out that it would not. I wasn't really THAT stressed out about it, but I just wanted answers and it was driving me half-mad not getting any. After finally getting some, I figured I had better order one last refill before the switchover took place so that I would be good on my injections until 30 weeks. I suppose if I go without after that, I'll just make friends with the couch even more than I already have and just lay low.

What makes me so mad is that, while I will be about one vile short, there are so many I know that are just starting this treatment or soon will be. That means that they'll be in a much different situation. The whole thing is just wrong! I hope that as this transition takes place, the insurance companies along with the pharmaceutical company work something out so that this will be affordable to those that need it -- $7500/vile is not affordable! I would think that covering this drug under an insurance plan would be much cheaper in the long run than the expense behind an unknown amount of NICU time for that poor preemie.

Oh well. That's my rant for the day. Luckily, after figuring all of that out yesterday and finally getting some answers, things have been very relaxed since then. Lunch with a friend, a movie with the hubs (Scott Pilgrim Vs. The World is an odd movie to say the least!), and visual movement from Samuel while hanging out -- can't beat it. I think the last aspect was by far the best.

Being 23 weeks along now, we've got one more week until our next peri appointment in Atlanta. We can't wait to see the little guy on the big screen again. Hopefully we'll continue to receive good news. Until then, I suppose we can sit and stare at my stomach and watch him move around now. I hope this little guy continues to grow and keeps that strong heartbeat!


  1. I think those are the injections that I'm supposed to start at 16 weeks because I am at risk for preterm labor. I wonder what my MFM will have us do now? Because I definitely can't afford that price!!

  2. I'm so sorry about all this! I was talking to Rhiannon about it and was glad to hear you'll be able to get them through 30 weeks, but like you said it's certainly not fair for those who will soon need them. I just hope that a more reasonable accommodation is met. Keep on keepin' on little Sam!

  3. It is just crazy that they are doing that. Time in the NICU would cost so much more money than covering the progesterone. I;m glad that you can get enough until 30 weeks. I hope it works out for everyone who needs it.

    I love that you can see Sam's movements through your belly now.

  4. glad it will get you through 30 weeks pris! continuing to pray for you and sam everyday!

    our world is SO messed up! :( i just don't understand! i'm sure they will see the prematurity rate skyrocket after this!

  5. I had read about what was happening with that drug and was so infuriated by the entire scenario. I am so glad that you were able to get that next vile, and I really hope that something is worked out by the time you need the last one. Surely to goodness the doctors/insurance companies/manufacturer aren't going to let women and babies in need go without. Can't they work something out!!?? I am so sorry you are dealing with all of that!
    I will be anxious to hear how your appointment goes today. I am thinking about you and Samuel! <3 Big big Hugs!!!