If you are diagnosed with a chronic disease, your mind will burst with multiple questions and thoughts in your mind. First of all, what you think about is the treatment cost. You must discuss the treatment options with your medical professional and then ask him how much infusion therapy cost.
So, first of all, let us have a look at what infusion therapy is. Infusion therapy is a treatment method by which fluids and medications are delivered directly into the body of a patient. Medical professionals say it is one of the most effective methods for treating chronic diseases.
In infusion therapy, the fluids are delivered into the body directly, and that’s why it gives immediate results. This blog will discuss the infusion therapy cost for patients in the hospital and at home. So, without any further ado, let’s get dive in to learn more:
Infusion Therapy Cost
While infusion therapy can be a highly efficient method to treat chronic diseases, it is often prohibitively expensive due to the extensive research that goes into producing these medications. Infusion therapy can cost $200 to $1,000 or more per treatment, depending on the type of medication and dosage, with many patients requiring multiple weekly or monthly treatments.
The infusion therapy cost 2022 varies for different types of infusion therapies. The treatment for infusion therapy can range in price from a few thousand to tens of thousands of dollars. According to a study of rheumatoid arthritis patients, the annual cost of RA infusion therapy in a hospital setting is projected to be between $36,000 and $47,000.
In addition to the cost of the infusible medications and biologic infusion from the manufacturer, there is a fee for the equipment, and medical staff required for an infusion facility to give the medication.
Infusion expenses vary depending on the medicine, dosage, location, and other factors. These expenses are passed on to insurance companies; the remaining balance is the patient’s responsibility.
Factors Affecting the Infusion Therapy Cost
Infusion therapy treatment varies and depends on the infusion therapy you receive from an IV center. Moreover, there are certain factors on which the infusion therapy cost depends. These are:
The cost of infusion therapy is mostly determined by the therapy. Certain drugs, such as Tepezza, can cost up to $16,000 per treatment (more than $150,000 per course of treatment), whereas Remicade can cost between $3,000 and $12,000 per treatment up to $50,000-150,000 per year.
The Frequency of Administration
The frequency is determined by the drug’s allowed frequency as well as orders by medical professionals. On average, patients receiving IV therapy are treated six times per year for continuous maintenance treatment.
The medications are costly primarily because they are hard to manufacture. Pharmaceutical companies spend billions of dollars on research and development for these medications.
Specialty medications are biological drugs with extremely complex manufacturing processes. Unlike regular oral tablets, specialty drugs require specialized transportation and storage. These factors impact the overall cost endured by patients and health plans.
Insurance Impact on the Treatment Cost
The amount the patient pays is ultimately determined by the patient’s insurance coverage. Every plan is unique. However, there are a few elements that patients should keep in mind. These are:
In the coinsurance, the patient pays a percentage or portion of the total expense of the treatment.
In copay insurance, the patients pay a fixed cost for the treatment that usually varies from $0-$50 per visit.
You must pay a certain amount of money under this plan before your health insurance plan begins to share costs.
- Insurance can also be a combination of any of these plans mentioned above.
Due to the high cost of infusion therapy, a patient will often reach their deductible in the first infusion of the year, resulting in low out-of-pocket payments for treatment during the rest of the year.
Site of Treatment
The only choice a patient has to impact the infusion cost is where they receive therapy. In general, a patient can get infusion treatment in one of three ways:
- Outpatient treatment in hospitals and IV centers
- Office Setting (Specialty Physician Office or Ambulatory Infusion Center)
In the hospital outpatient, 50-60% of the infusion therapy treatment takes place. You may think that how much does home infusion therapy cost? The cost of receiving treatment at an outpatient hospital is double compared to receiving the treatment in-office or at home.
Home infusion has attracted a lot of attention recently, although the National Infusion Centre Association reports that it is usually 50% more expensive than going to a healthcare provider’s office.
The office setting will be the most cost-effective treatment option for patients who have obtained a referral from their physician for infusion therapy.
How Insurance Covers Infusion Therapy?
When your insurance company considers your coverage for infusion treatments, they will look at two essential factors:
- The therapy, which is the method of administration of the medication.
- The medication is the drug that has been prescribed to be infused.
Your insurance company will require a prescription from your doctor before determining coverage. Most insurance companies will not pay for infusion therapy unless it is for chronic disease. Clinical notes from your doctor may be required to substantiate your need for the medicine.
What if you do not take my insurance?
We may be allowed to bill your insurance carrier out-of-network even if not in-network with your insurance plan. We can also see you as a Self-Pay patient if you do not have out-of-network benefits. If you require any additional information, please do not hesitate to contact our team.
What is copay assistance?
Copay assistance is financial support that helps patients with insurance who are underinsured pay for copays. Underinsured means you have out-of-pocket expenses that your health insurance does not cover and cannot afford. This could include the amount you pay for your health insurance premium.
Who is eligible for copay assistance?
Program eligibility varies, but in general, anyone with private health insurance (but not Medicare or Medicaid) can participate in a copay assistance program. You are not usually required to demonstrate that paying your standard payment for the prescription would cause you financial hardship.
Discuss Your Financial Concerns with Fuse Infusion
If you are facing a new diagnosis, it may be stressful, and the last thing patients want to be concerned about is how they will pay for their medication. Speak with your provider if you are concerned about the expense of infusion therapy. They may be able to provide or recommend other resources.
Do you have any questions about infusion therapy costs? Fuse Infusion’s team assists patients in affording their medications. To discover more about your eligibility for financial aid programs, please contact a member of our staff, or visit our website www.fuseinfusion.com