You may be wondering how, in the wake of healthcare reform, Bayer has seen fit to raise the price of a Mirena IUD to over $700.
Some providers are outraged, and concerned that they will no longer be able to afford to provide this contraceptive method for their patients.
But check out this thread on the Café Pharma boards, where drug reps in the know think the price increase came because Bayer got an indication for use of Mirena to treat heavy menstrual bleeding –
Mirena prices are already high. I assume the increase is do to the MBL indication. I have never seen a forcast but guessing it could add 100 million to the US market.
That seems about right to me. Mirena has moved from a contraceptive market, where it must enter the field in the same price range as its competitors, to the abnormal bleeding market, where its new price compares quite favorably to interventions such as surgery and endometrial ablation.
And sure enough, it looks as if the plans are already buying into the new price –
Due to a recent price increase by the manufacturer, UMP has increased the allowed amount for the Mirena IUD from $515.85 to $742.42, effective March 15, 2010. Claims for dates of service from March 15, 2010 and later will be paid based on the higher allowed amount depending on the network status of the provider (network 85%; non-network 60%).
Wonder when the birth control pill manufacturers will get wise and try the same thing? After all, we’ve been prescibing oral contraceptives to treat heavy periods for years.
And the game goes on. The losers, in the end, will be the uninsured. Oh wait – there will be no more uninsured now that healtcare reform has passed. I think I finally get it…
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Updates
- It appears Medicaid has also adjusted its reimbursement to match the new price. So relax, everyone.
- Docs who don’t want the upfront expense of stocking Mirena can have patients obtain it directly from Caremark through their insurers (though I’d always keep a backup or two around the office in case the one the patient brings drops or is defective…)
- Bayer has a program to assist uninsured women with the cost of Mirena
I think this is outrageous. One, because this is an awesome birth control option for so many women and two, because I want one! Even so, when you average out the price of either a pregnancy (or two or three) or OCPs plus lots of tampons/pads $700 is still a very reasonable price for effective birth control. It's awesome now that it has new indications as well.
OK, Schruggling rant coming.
Who cares if the uninsured can't afford this? There are SO many BC options that are easy and affordable. This product is a lifestyle choice, and is so optional, I actually find it outrageous that insurance should cover it at all! People don't have a right to everything. Conversely, Bayer HAS the right to charge what they can. It's still a capitalist society, and if you have the cash to get a better product, fork it over. Those who are uninsured can pay $4 at Walmart for oral contraceptives anytime, thank you very much.
ELizabeth – I agree that in the long run IUDs are cost effective methods of birth control.
Schruggling – On one hand I agree that there are lots of options out there. But if you cover one, you need to cover them all. The choice of methods is not necessarily dictated by lifestyle- there are medical reasons why one might be better than another for a given woman. And while Walmart's pills are cheap, they are not appropriate for every single woman.
On another note – Are you ready for the throwdown?
Well, I'm glad to have this heads-up since my Mirena is due for replacement in less than a year. Hopefully my insurance will still cover it at 80% and it just means I write a bigger check without having to get and bring it in myself (yuck). I'd say it was totally tempting just to switch over to Paraguard, except I don't want to return to any level of bleeding. (((sigh)))
Money makes the world go around.
May 15. John is waiting. Patstisio THROW DOWN!
I will have the kitchen ready in stations for prep. Also, plenty of wine, a few munchies, music, etc.
And for the record, I completely disagree that all products should get covered under insurance. Not all drugs are now, and rightly so I think.
But you know I completely disagree with hugs and kisses, right?
Glad to hear your plans are increasing reimbursement. CIGNA and United Health Care haven't increased squat in my state. So it looks like a lot more of our folks will be going through Caremark.
Oh, no. I just recommended that my cousin Susan talk to her ob/gyn about Mirena for her dysmenorrhea and menorrhagia. I told her it would probably be covered by her insurance. Ehhh, maybe not now!
I'm from Australia, and Mirena was indicated for heavy menstrual bleeding first, and then a few years later it got the indication for Birth control. I just have had a Mirena for myself, and it cost $32 to buy (then extra cost for the OBGYN to insert the device). If I had the equivalent of Medicaid, it would have cost me $5. Quite a big price difference, but I don't really know the money amount that the government co-pays.
Rebecca
I just ordered one from a Canadian pharmacy that I have used in the past – it cost $225.
I'm a Pharmacist here in Australia, and the current cost price (reimbursed to Pharmacies) is $246.41
I've attached the link with the current prices – it would be $33.30 for a normal patient and $5.40 for concession patients: disability pension, unemployment, etc.
http://www.pbs.gov.au/html/healthpro/search/results?term=mirena&scope=PBS+STATIC+WEB+NEWS&form-type=simple
This is part of the reason most of the rest of the world doesn't understand all the scaremongering you guys have about government involvement in health care!
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