Huge Nplate price drop?

I was reviewing my medical claims for October and noticed a massive drop in the "Billed amount" and "Paid amounts" for my weekly Nplate injections.
Previously Since late September Billed $3625 $1305
Medicare Paid $1350 $500
Mutual of Omaha $338 $125

That is an amount paid difference of $1063. Instead of $1850 a week the paid amount is $625 almost 1/3 of prior cost. Saves my insurers $63,700 a year!!!!!

A pretty amazing price drop which I have no explanation for! Has anyone else on Nplate seen this change? I would only guess this drug may have come off patent and there may be a generic version in the future?

That is very interesting Thomas! Is your dose still the same? I will check into it as I'm also on Nplate. It takes forever for my claims to go through so may take a while. I really hope the price has gone down, perhaps it would allow more people to have access to the drug. AND I won't feel so guilty being on it! haha

Mine is paid for by a Medicare advantage plan, so the charges aren't separated by Medicare and insurer. I just checked to answer your question and found the latest charges are actually a few dollars more than the ones from August. My last dose of 365 mcgs was reimbursed at $3343.

Would be lovely to think the price has dropped so more people could get access. I'm like Posey... Feeling pretty guilty about what's being spent on me for a condition where I don't feel the least bit sick.

I agree about feeling guilty at being 100% covered at such high prices. My dose is the same at 1mcl/kg and my weight has not changed. If there has been no price change they may have started using a 3rd size bottle to the pharmacy for low dose patients. This would eliminate a LOT of waste as they can not store or share reconstituted Nplate. The smallest bottle was 250mcl, maybe they came out with a 100 which would cover my needs. Let us know what you are seeing on your October EOBs. I am cruising on my dose from 90-120 counts and extremely satisfied with Nplate.

Thats great you only need a small dose Thomas. I get 400mcg per week. And since the vials come in 250, every week there is 100mcg wasted- down the drain! Thats so much money!
I suggested to the clinic that they schedule all the people who get Nplate to come on the same afternoon so the leftovers from one person can be given to another person. But they said they can't do that. By law, they have to throw it away- so crazy. They told me that some people can't afford the drugs they need, but still the clinic has to (by law) dump the drugs rather than give them to someone for free.

Same over here in the UK. The waste involved is horrendous. All unused medicines are disposed of. I can understand if it's a bottle that has already been opened but blister packs and boxes with intact tamper seals is ridiculous.

Yes poseymint I am very fortunate to have responded to the minimum dose per KG! I am very satisfied with treatment so far. Most here probably have not read the specific Amgen instructions to the pharmacist on preparing and administrating Nplate. Evidently Nplate is extremely unstable when prepared and the shelf life is nil. We need the fresh stuff! My concern has always been package sizes of 250 & 500, when I and others only need 90. A package size of 100 only would make much more sense to the user with almost no waste. I am pasting from the package insert here: Gently swirl and invert the vial to reconstitute. Avoid excess or vigorous agitation: DO NOT SHAKE. Generally, dissolution of Nplate takes less than 2 minutes. The reconstituted Nplate solution should be clear and colorless. Visually inspect the reconstituted solution for particulate matter and/or discoloration. Do not administer Nplate if particulate matter and/or discoloration is observed.
Reconstituted Nplate can be kept at room temperature (25°C/77°F) or refrigerated at 2° to 8°C (36° to 46°F) for up to 24 hours prior to administration. Protect the reconstituted product from light.
To determine the injection volume to be administered, first identify the patient’s total dose in micrograms (mcg) using the dosing information in Section 2.1. For example, a 75 kg patient initiating therapy at 1 mcg/kg will begin with a dose of 75 mcg. Next, calculate the volume of Nplate solution that is given to the patient by dividing the microgram dose by the concentration of the reconstituted Nplate solution (500 mcg/mL). For this patient example, the 75 mcg dose is divided by 500 mcg/mL, resulting in an injection volume of 0.15 mL.
As the injection volume may be very small, use a syringe with graduations to 0.01 mL. Verify that the syringe contains the correct dosage.
Discard any unused portion. Do not pool unused portions from the vials. Do not administer more than one dose from a vial. <<<<< there is your WASTE!

Wow. Sentara is billing optima $15k a shot every week for my injections. When i got the first EOB i was shocked and thankfull my out of pocket was met.

John

That sounds like major price gouging. Is Sentara a hospital? Hospital's are known to charge excessively for many/most tests, treatments, etc. The pity is that insurers play along with their game.

As far as a I can tell, the going rate these days for a 500-mcg vial is somewhere in the vicinity of $3500... About what my insurer is paying for mine.

Thanks Thomas- I had never read that about Nplate, very interesting. I wonder then how can they self-inject in the UK? I thought they were given a months supply already in the syringes, such as 4 syringes. I may be wrong on that. But if you'd have to use it right away, there would be no point in self-injecting.

My dose was getting up close to the 500mcg cut off. It was 495 last year. that motivated me to lose weight- haha whatever it takes right? I lost 20lbs just out of fear of going over 500 into another vial and feeling totally guilty over the cost! Then for some reason I didn't need as much Nplate so with the weight loss, I am now down to 408.5mcg as a weekly dose. I've been stable on that dose for one year. As you said, finding something that works is great.
My hospital group charges $12,000 per dose to my insurance. But then they negotiate the price down to $4000. I think its just a game they play. If the hospital charged the insurance $4000 then the insurance might want to pay only $600 or something. Its mad and yes- tons of waste. Having 100mcg vials is a very good idea.