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    Costs of Interstitial Cystitis in a Managed Care Population
    Thursday, 05 June 2008

    BERKELEY, CA (UroToday.com) - BPS/IC Costs Exceed $4000 Annually In Managed Care Population

    UroToday.com - Although it is evident that patients with BPS/IC use significant healthcare resources, the degree of economic burden attributed to the condition has been incompletely studied. Clemens and colleagues from Chicago and Portland attempted to quantify the direct medical costs to the healthcare system associated with a diagnosis of BPS/IC and to examine condition-specific medication and procedure patterns in patients with the disorder. The study population included members of the Kaiser Permanente Northwest, a health maintenance organization based in Portland, Oregon.

    They found that mean yearly costs were 2.4 times greater for patients than for controls ($7100 versus $2994) and the median yearly costs were 3.8-fold greater ($5000 verses $1304). The costs differences were mainly a result of outpatient and pharmacy expenses. An analysis of medical comorbidities suggested that the excess costs for the patients were more likely attributable to BPS/IC than to accompanying comorbidities incorporated into the treatment-risk model. The relative cost difference was most pronounced for the youngest individuals (25-50 years).

    The authors note that the costs presented in their analysis may have underestimated the true cost of the disease for a number of reasons. They did not reflect IC-related costs accrued before diagnosis and did not included services not covered by Kaiser. They did not incorporate indirect costs, which are much harder to measure, such as work loss due to symptoms. Without a reliably effective treatment, this cost structure could persist for extended periods.

    Clemens JQ, Meenan RT, Rosetti MC, Kimes T, Calhoun EA

    Urology. 2008 Mar 6 (Epub ahead of print)
    doi: 10.1016/j.urology.2007.11.154

    PubMed Abstract
    PMID: 18329077

    [email protected]his email address is being protected from spam bots, you need Javascript enabled to view it

    UroToday.com IC/PBS/BPS Section

  • #2
    Frankly, those numbers sound low to me. I know I spend more than that per year, even with pretty good insurance. Sigh.
    Je vous souhaite de la joie, de la bonne santée, et tout ce qu'il y a de bon dans la vie.
    Wishing you happiness and good health, and all the best out of life.

    Peace, Carolyn
    ___________________________________________________

    Laura (11), Susannah (12 1/2) and Maman (that's me!), North Wildwood NJ, September 2007


    On the Beach with IC

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    • #3
      I'm very thankful that I have good insurance coverage. I don't know how we'd manage without it!

      Donna
      Stay safe


      Elmiron Eye Disease Information Center - https://www.ic-network.com/elmiron-p...mation-center/
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      [3MG]

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      • #4
        I know I spend much more also........but, the good thing is that they are studying aspects of IC/PBS, including cost. Hopefully, that will stimulate interest in the research of cures. Hopefully it does not make people with IC uninsurable in the future. A two-edged sword.
        Julie Beyer, MA, RDN
        IC Dietitian, Patient Advocate, Speaker, & Author


        Did you know that up to 94% of interstitial cystitis patients find some symptom relief when they change their diet, and that dietary modification is recommended as a first line treatment for IC? Check out the IC Food List to get started!

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        You can also learn more while supporting the ICN message boards by clicking on these book covers and buying the Confident Choices books from the ICN Store:

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        • #5
          I work for the State of Texas - we have real good insurance (BC/BS) - it use to be better a handful of years ago but they had to change things which I understand due to the high costs of medical expenses; but I can't complain as everything is reasonable- I feel very lucky to have insurance because I know that there are others who don't.

          Comment


          • #6
            Originally posted by Berkshire Road View Post
            Frankly, those numbers sound low to me. I know I spend more than that per year, even with pretty good insurance. Sigh.
            With two hydros a year my costs are above the median there. I agree with Berkshire Rd costs seem low there. I was trying to see if their were titles behind this name on the published study. I have an insurance company that won't let you have certain medications etc. I somehow don't think a study showing the average cost of an IC pt in a managed care plan is going to be a positive thing. Insurance companies get ahold of that info and they could change things for IC pts on anything they want. Vicky

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            • #7
              I have good insurance too BCBS and the amounts seem pretty close. But if I didn't have any or didn't have good insurance I know it would be well over that about. With all the office visits, PT, medication, instills alone would be over that amount. Also, I am 26 and most of the people my age don't have any problems at all. They maybe go to the doctor once a year and might average 1 perscription or less a year.

              I pray that this study and subsequent ones don't make it harder for us to get insurance or make it harder to use benefits. I really think it is wrong for a company to acknowledge a problem and then refuse to treat it. A good example is TMJ or TMD. Hardly any company covers treatment in it, and if they do there are usually max life benefits.

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              • #8
                Blue Cross of California

                My costs JUST for insurance premiums are $639.00 per month. My co-pays for meds are over $38,000.00 in the last 9 years. I finally received PAP from J&J for Elmiron and that has reduced my rx co-pay costs $250.31 per month.

                But, Lidocaine 4% is $100 per month and one # 25 Heparin is $46. I only use Heparin for break through instillations between the 2 Elmiron instillations. Then there's Bicarb which only is dispensed in lots of 50 50cc bottles....

                All of us need to write letters to legislators regarding the terrible burden some of us carry. Then, there are always good lawyers who will take cases on a contingency - no money up front and a % ONLY if the case is won.

                Look up Elizabeth Black v Blue Cross. The case can easily be googled.

                Our healthcare system needs a major overhaul. Those of us unfortunate enough to not be able to work and get group insurance pay through the nose and the benefits are constantly, unilaterally shredded. Paying for IC and the **** other co-existing illnesses is almost as stressful as the diseases themselves.

                Comment


                • #9
                  I worry that this information will make it harder for us to get insurance and I know we must have insurance. On the other hand, I know that companies that sell drugs develop and study conditions when there is money to be made.
                  Daily Meds:

                  IC-Meds
                  Ditropan XL 5 BID, Elavil 50 QD, Elmiron 200 BID, Hydroxine 50 BID. As Needed: Bacofen 20, Prosed DS, Hydrocodone/Apap.

                  Other Meds
                  Adderal 10 QD, Remmeron 37 QD (I take 1 1/2 of 25 mg)

                  With the help of my doctor moving my meds around a bit by increasing this and decreasing that I have found a good combination of meds (for now and I pray a long time from now).

                  Comment


                  • #10
                    Originally posted by j56 View Post
                    My costs JUST for insurance premiums are $639.00 per month. My co-pays for meds are over $38,000.00 in the last 9 years. I finally received PAP from J&J for Elmiron and that has reduced my rx co-pay costs $250.31 per month.

                    But, Lidocaine 4% is $100 per month and one # 25 Heparin is $46. I only use Heparin for break through instillations between the 2 Elmiron instillations. Then there's Bicarb which only is dispensed in lots of 50 50cc bottles....

                    All of us need to write letters to legislators regarding the terrible burden some of us carry. Then, there are always good lawyers who will take cases on a contingency - no money up front and a % ONLY if the case is won.

                    Look up Elizabeth Black v Blue Cross. The case can easily be googled.

                    Our healthcare system needs a major overhaul. Those of us unfortunate enough to not be able to work and get group insurance pay through the nose and the benefits are constantly, unilaterally shredded. Paying for IC and the **** other co-existing illnesses is almost as stressful as the diseases themselves.
                    I am totally with Jan on this we ALL need to write our congressmen. I will google that Black v bcbs thanks for that Jan. I am also like Jan on disability and paying 700 premium for cobra. Looks like when I am off cobra I thought my premium would be better- not really if Jan is paying 639 for private individual insurance. I also expect once off cobra to pay the high prescription copay that Jan has mentioned. I disagree with that article and the money figures given for managed care in IC are too low. Vicky

                    Comment


                    • #11
                      Yeah well, there are lies, damn lies, and statistics, as the great Mark Twain had it.

                      I'm sure costs for IC/IBS in managed care are lower bc. the insurers deny approval for procedures and meds, and the majority of patients lack either the knowledge, the energy, or the will to keep on protesting until they do. Way to keep those costs down! (Who, me? Cynical?)
                      Je vous souhaite de la joie, de la bonne santée, et tout ce qu'il y a de bon dans la vie.
                      Wishing you happiness and good health, and all the best out of life.

                      Peace, Carolyn
                      ___________________________________________________

                      Laura (11), Susannah (12 1/2) and Maman (that's me!), North Wildwood NJ, September 2007


                      On the Beach with IC

                      Comment


                      • #12
                        "who me cynical" Uh UH

                        Carolyn,

                        No, not cynical. Realistic and informed. Those qualities make healthcare reform fighters. I am proud to count myself among that group.

                        There's a book called "How To Fight Your Insurer and Win" by Laurie Todd "The Insurance Warrior." Laurie is a 2 yr. rare cancer of the appendix survivor who had to fight her insurer and her disease with a determination and strong will that is nothing short of amazing.

                        I personally think this is a "must read" for anyone whose medically necessary care has been DENIED. She also offers consults too if you need her personal help. YOu could also Google "The Insurance Warrior" and find the site too I think.
                        Last edited by SharonA; 06-20-2008, 09:18 AM. Reason: removed website address

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