Cost of Lupron out of pocket?

beachgal0114

We're seeing an RE in January to get a second opinion about our chances of conceiving naturally.  If he says that our chances are pretty low and we need IVF, I'm considering asking him about going on Lupron until we're ready to do IVF later in the year (we can't afford it until DH graduates and starts working).   I have stage III endo and my last surgery was nearly two years ago, so I'm pretty sure it's back.   However, my insurance doesn't cover any fertility treatments or associated meds.  What's the cost of Lupron out of pocket? TIA!

groovygrl

Do you mean depot lupron, which is a treatment for endo? I don't think too many people would prescribe the daily lupron just on its own, but I'm not sure.

Anyway, if you've been diagnosed w/ endo, your insurance might cover the depot lupron injection since it is a treatment for endo, not technically for IF. Mine does not cover ARTs but did cover my depot lupron & I just had to pay the copay. Worth looking into!

GL! 

beachgal0114

Yes, I mean the Depot Lupron (sorry, didn't realize there was a difference between the two!).  The problem is, I'm not sure I can get my regular OBGYN to prescribe it as he's in the "try for six months and then we'll talk" camp and is very anti-Lupron.  I feel like he's being too laid back about our situation, which is why I'm getting a second opinion from the RE.  If the dx and prescription come from the RE, I'm not sure insurance will cover it, though that's something to look into.  I'm just trying to get a ballpark estimate in case we do have to pay OOP.

groovygrl

Hi again-

My RE prescribed mine & it was covered. The IF use of it is off label I'm pretty sure (and controversial) so it is generally viewed as treatment for endo not IF. (the daily lupron most people on this board are referring to is used in conjunction with IVF protocols)

It's worth a call to your ins co & also try calling Schraft's Pharmacy- it is the Walgreen's fertility specialty pharmacy, that is where mine came from & where I order a lot of my meds, they have decent prices. Plus they can let you know about special programs you might be able to enroll in for discounts. Their number is  800-876-4545.

GL! I looked at my old stuff to see if the real price was listed but only my copay was listed... 

micheleleigh

Hi beachgal, I just want to let you know that my RE does not recommend Depot Lupron for endo patients. She says that sometimes the ovaries choose not to "wake up" after being suppressed. Also, Lupron causes early osteoporosis and is not safe to be on for more than three months. I will be curious to know if your RE says any differently.

Be prepared to hear that IVF is your main option. It is a tough pill to swallow. I think whether your insurance covers Lupron probably depends on your coverage. I have United Healthcare and it is covered, although I'm not sure of the cost. Sorry I'm not more help!

groovygrl

micheleleigh:

Hi beachgal, I just want to let you know that my RE does not recommend Depot Lupron for endo patients. She says that sometimes the ovaries choose not to "wake up" after being suppressed. Also, Lupron causes early osteoporosis and is not safe to be on for more than three months. I will be curious to know if your RE says any differently.

Just wanted to follow this up--- all good points, the suppression is a big concern for a lot of people although there are those that believe the oversuppression is only a concern in those with low ovarian reserve to begin with. If you have never been on Lupron, it is a good idea to do your research & know the risks (but try to stay away from some of the crazy websites that are out there, they will not help you). If you're using lupron more for IF, chances are you will not be on it for more than 2-3 months, but you can take supplements to help with any potential bone loss if it is a concern to you. I'm not trying to be all pro-Lupron because there are many drawbacks & it took me months to finally decide to use it (I even emailed some researchers & whatnot!), but just trying to present different sides. GL. 

b3bell

I was on lupron depot for six months in college for my endo - my insurance covered it.  Lupron depot was also part of my protocol for this ivf cycle.  I have no IF insurance coverage and my insurance again paid for it because its main use is for endo.  In response to your question regarding cost - the price I was quoted oop would have been about $750. 

groovygrl

Good god, I had no idea it was that much OOP. That is craziness.

beachgal0114

Thanks everyone for your responses!  Michele--I figure that's what we're going to hear, but I've heard many varying opinions on Lupron.  I'll definitely let you know what the RE says.