What ACT costs are incurred with a mechanical valve?

[Duffey]

I've been a member of VR since 2004, but I don't remember a thread discussion about costs associated with anticoagulation for a mechanical valve.

I suppose in the States there are two general categories?

1. Home monitors

How much is the initial cost of a machine? How much do supplies cost? Are they covered by insurance? If so, how much does does insurance cover?

2. Doctor's offices and clinics
How much is a visit? How often do you test? How much does insurance cover?

How much is the cost of coumadin? Does insurance cover the cost?

Overall, what's a ballpark estimate for your annual expenditure?

 

[Freddie]

I've been a member of VR since 2004, but I don't remember a thread discussion about costs associated with anticoagulation for a mechanical valve.

I suppose in the States there are two general categories?

1. Home monitors

How much is the initial cost of a machine? How much do supplies cost? Are they covered by insurance? If so, how much does does insurance cover?

2. Doctor's offices and clinics
How much is a visit? How often do you test? How much does insurance cover?

How much is the cost of coumadin? Does insurance cover the cost?

Overall, what's a ballpark estimate for your annual expenditure?

I guess you don't want a Canadian figure.

 

[Duffey]

Yes, I do want a Canadian figure. I'm guessing that it will be significantly less, but that's only a guess.

 

[Philip B]

Costs

Costs

Costs vary widely as insurance coverages vary. Costs also depend upon how often people test.

Costs for lab testing where I lived were around $75.00. Insurance didn't mind paying for weekly testing.

My initial cost of my INRatio monitor was around $1,100.00. Insurance didn't cover the initial cost, but I was able to get reimbursed after battleing with insurance reps for over six months.

Insurance covered the cost of my first 12 pack of test strips ($18.00 per strip). The company later changed course and refused to cover any more test strips. Purchasing strips in 48 count bulk packs lowered my cost to around $5.00 per strip.

Coumadin costs also vary. When I lived in Colorado, I used to pay $4.00 for a bottle of 90 pills. My most recent coumadin purchase in Arizona was $8.00 for a bottle of 90 pills.

Costs for lancets and alcohol wipes are pretty low as I purchase these things at a discount pharmacy.

-Philip

 

[dick0236]

I've been a member of VR since 2004, but I don't remember a thread discussion about costs associated with anticoagulation for a mechanical valve.

I suppose in the States there are two general categories?

1. Home monitors

How much is the initial cost of a machine? How much do supplies cost? Are they covered by insurance? If so, how much does does insurance cover?

2. Doctor's offices and clinics
How much is a visit? How often do you test? How much does insurance cover?

How much is the cost of coumadin? Does insurance cover the cost?

Overall, what's a ballpark estimate for your annual expenditure?

Duffey, you are going to get all kinds of numbers....heres mine.

1. Home Monitoring....I have been in a "lease" program with Alere. They provide monitor, strips, lancets, etc. at no cost to me. Anthem allows about $30/test
and pays $24. I pay $6/test. I have been testing bi-weekly.

2. I am in the process of returning to my cardios INR lab for testing. The cost of each test will be $16 and Anthem will pay $16. My doc does not charge for an office visit and my cost will be -0-. I probably will test monthly(maybe biweekly).

The cost of warfarin is nominal. Most pharmacy chains offer 30days for $4 and 90 days for $10, regardless of strength. My insurance co-pay is -0-. The brand name, Coumadin is somewhat higher(in 1980 Coumadin was over $100 for 30 tabs), but its use is becoming less over time.

The annual cost of ACT is nominal with, or without, insurance and should be no more than a few hundred dollars annually without insurance and near -0- with insurance.

 

[nngbwh]

Once a month at a clinic if my INR is stable. I pay nothing to get my INR tested. My co-pay is $10.00 for 30 days supply of warfarin 5mg and 1mg at a local pharmacy.

 

[Freddie]

I've been a member of VR since 2004, but I don't remember a thread discussion about costs associated with anticoagulation for a mechanical valve.

I suppose in the States there are two general categories?

1. Home monitors

How much is the initial cost of a machine? $500.00CDN How much do supplies cost? aprox $180.00 for 24 strips, aprox $15.00 for 50 lancets Are they covered by insurance? If so, how much does does insurance cover? Just the lancets 80%

2. Doctor's offices and clinics
How much is a visit? No chargeHow often do you test?Every 2 weeks How much does insurance cover?there is no charge for either - both are free of charge

How much is the cost of coumadin? $61.88 for a 3 month supply for 1's and 5'sDoes insurance cover the cost? it covers 100%

Overall, what's a ballpark estimate for your annual expenditure?

for 1 year aprox $180.00 for the strips - did not include the lancets since the box has 50, so that will last me 2 years

 

[Bina]

mary, we do discuss the prices of these items on occasion, but the posts are scattered about in different threads.
My ACT supplies and monitor are considered a bargain when I think of the prices of some newer meds.

Monitor............$495 paid for and owned by me, a single expense and is submissable as a tax deduction.
Test Strips.......$182 per year (24 strips- testing ~ every 2 weeks) insurance pays 80% my share is about $36 per year
Lancet needles $ 10 for 50 needles lasting me about 2 years.
Coumadin........ $ 10 average per month and insurance pays 80%
OR
Blood test anytime at the local hospital is free and the Coumadin meds remain at the same cost (very little).
ACT for me, even being a home tester, is a total bargain and that makes it way easier to deal with.

 

[Freddie]

okay, I may have over estimated on the lancets comparing with Bina's prices - I don't have the receipts in front of me

 

[catwoman]

I figure about $290 per year (about $250 for 48 testing strips, $30-40 for 2 90-tab bottles of 10mg tabs and 1 or 2 90-tab bottles of 1mg tabs. I halve the 10mg and 1mg tabs to stretch my Rx $)
I paid about $600 in 2008 for my INRatio. I figure I've recouped that several times over in gasoline and lost worktime/sicktime (estimated at 12-30 hours/year) I would have lost due to Dr. appts for INR tests. I get 5 sick days per year.
I bought lancets a year ago on sale at Walgreen's and have enough for at least 12-18 more months. At least that long.

 

[New Guy]

Hi Marsha,

Where did you purchase your INRatio machine? I'm looking to buy soon and prices I've seen are twice what you paid. Maybe they got more expensive.

Doug

 

[ALCapshaw2]

Hi Marsha,

Where did you purchase your INRatio machine? I'm looking to buy soon and prices I've seen are twice what you paid. Maybe they got more expensive.

Doug

Some suppliers seem to have a dual pricing scale.
One for Insurance. One for "Cash Sales" (which is about half the Insurance Charge).
Make an Offer and see what they say!

 

[Cooker]

My insurance allows me to test as often as needed at the vet's office, with no co-pay ... at CVS my warfarin is $9 a month but I had the vet write the script for 10mg and I break them in half so I guess I'm spending $4.50 a month .... the office is full of hotties so it is no chore to visit the office once, twice, three .... :tongue2:

 

[AgilityDog]

When I was on the "lease" program with Raytel, I paid $50/month co-pay
Then Raytel sold to Phillips, and Phillips changed the insurance coding. I got charged $258/month, that I had to pay for several months before I figured it out and cancelled (I thought it was just a billing error), because of my high annual insurance deductible.
So I cancelled the "lease" and bought my own machine, about $750.
I buy a box of 48 strips for about $250, which lasts me 9+ months, since I manage to muck up one or two every few weeks, or get a weird reading, or an error code, or....
warfarin is $10/90 days x 2 dosages, which wind up lasting longer than 90 days, of course.

Moral of the story: FIND OUT WHAT YOUR INSURANCE WILL PAY, ETC. BEFORE YOU LEASE!

 

[Duffey]

From the replies so far, can I generalize and say that the cost of testing at a clinic or doctor's office is nominal while home testing might run several hundred dollars in the U.S. but less in Canada?

 

[olefin]

I'm on Medicare and have a supplemental policy that covers the amount Medicare doesn't pay. Therefore all medical bills and my home testing cost is 0. Warfarin cost $10 for a 3 month supply. My Cardiologist approves me taking care of dosage.

 

[Duffey]

How much did your machine cost and was it covered by insurance?

 

[ShezaGirlie]

Cost containment...

Cost containment...

This is a timely and interesting question for me since I will leave my Medicare Advantage insurance program and go instead to the traditional Medicare program plus a supplement insurance policy ~ as of Jan 1, 2011. The 'open enrollment' period begins in just over a week, so I am studying up..

To answer your questions:

1999 - contacted Roche and got a CoaguChek machine directly from them as my insurance deductible was $7,500 the machine cost around $1,200. I bought my strips directly from Roche and they were around $7 each.

2002 - contacted Roche UK and got a CoaguChek S machine directly from them and gave them my credit card over the phone the machine cost around $600USD. I bought my strips directly from Roche UK and they were around $3 each.

2009 - contacted QAS and got a CoaguChek XS machine directly from them on a lease basis since I was now part of the Medicare scheme for INR testing. My Medicare Advantage insurance has paid for the strips, so cost to me currently is $0 per year.

I don't know how much the strips will cost as of Jan 1, 2011 when I go on Medicare or how much the Medicare supplement insurance policy will pay for the strips. The machine will still be on a "free" lease basis which is part of the Medicare scheme. I don't like the discipline of testing weekly, but I have never been more stable either.

I called Alere to question the cost of the strips and their insurance guru told me that Medicare pays them $20 per test and I would be responsible for the other $8 due per strip. This means that the Medicare scheme is paying $28 per test.

Isn't that insane when I can go to my cardio's office - 2 blocks - and test on their CoaguChek XS using their strip for $15. What's wrong with this picture?!?! This is how insurance companies are ripping off the government and us taxpayers..!!

Medicare needs a BIG TIME reform..!!

Something I learned the other day on a visit to my dermatologist for the first time since I've been on the Medicare scheme. Physicians can only charge you as much as Medicare pays them for the same service. Of course, my dermatologist isn't on my Medicare Advantage HMO list, so I was on my own. How nice to get out of that office for only $38...:biggrin2:

 

[Duffey]

This is a timely and interesting question for me since I will leave my Medicare Advantage insurance program and go instead to the traditional Medicare program plus a supplement insurance policy ~ as of Jan 1, 2011. The 'open enrollment' period begins in just over a week, so I am studying up..

To answer your questions:

1999 - contacted Roche and got a CoaguChek machine directly from them as my insurance deductible was $7,500 the machine cost around $1,200. I bought my strips directly from Roche and they were around $7 each.

2002 - contacted Roche UK and got a CoaguChek S machine directly from them and gave them my credit card over the phone the machine cost around $600USD. I bought my strips directly from Roche UK and they were around $3 each.

2009 - contacted QAS and got a CoaguChek XS machine directly from them on a lease basis since I was now part of the Medicare scheme for INR testing. My Medicare Advantage insurance has paid for the strips, so cost to me currently is $0 per year.

I don't know how much the strips will cost as of Jan 1, 2011 when I go on Medicare or how much the Medicare supplement insurance policy will pay for the strips. The machine will still be on a "free" least basis which is part of the Medicare scheme. I don't like the discipline of testing weekly, but I have never been more stable either.

I called Alere to question the cost of the strips and their insurance guru told me that Medicare pays them $20 per test and I would be responsible for the other $8 due per strip. This means that the Medicare scheme is paying $28 per test.

Isn't that insane when I can go to my cardio's office - 2 blocks - and test on their CoaguChek XS using their strip for $15. What's wrong with this picture?!?! This is how insurance companies are ripping off the government and us taxpayers..!!

Medicare needs a BIG TIME reform..!!

Something I learned the other day on a visit to my dermatologist for the first time since I've been on the Medicare scheme. Physicians can only charge you as much as Medicare pays them for the same service. Of course, my dermatologist isn't on my Medicare Advantage HMO list, so I was on my own. How nice to get out of that office for only $38...:biggrin2:

Janie,
You paid a total of $7,200 for machines bought in 99 and 02? I don't know the ins and outs of testing . . . . you now test weekly, so 52 strips a year?

 

[ShezaGirlie]

I paid $1,200 + $600 = $1,800 for the two first machines. In the early years I never tested weekly - overkill, I thought.

However; since I went on Medicare in 2009 I joined the Medicare INR testing scheme where Alere owns the machine, leases/loans it to the patient and the patient buys the strips. There is no lease fee on the machine, so basically it's on a loan, but I'm quite sure Medicare either provides the machines to Alere or they buy them and 'manage' the testing.

Yes, now I test weekly, so it's 52 strips a year.. Alere makes $1,456.00 a year off Medicare and either me or my insurance.