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Re : Synagis shots....

Posted: Tue Jan 03, 2006 04:03 pm
by darcynulph
My DD gets her shot monthly, it cost $1500 because I won't take her to the clinic and it is covered by our insurance. From my understanding every baby in Arizona born before 32 weeks gets the shots series, whether or not you have private insurance.

The nurse that comes to our house said that it may reduce the risk of rsv as much as 97% which I don't know is true. Even if it reduced her risk by 10% I would have her on it.

I think the way to get the insurance companies to cover it is to contact the pharmaceutical company that makes it. They have professional lobbyist that can put the pressure on the insurance companies to cover it. With a group of determined Mom's and the greed of the pharmaceutical company anything is possible....Just a thought...

Re : Synagis shots....

Posted: Tue Jan 03, 2006 01:37 pm
by whosures
Riley got the shots for two cycles and we were thrilled to get it! Our insurance covered it, no questions asked.

Re : Synagis shots....

Posted: Tue Jan 03, 2006 12:34 am
by jenandtheboys
I understand what you mean, Sue Ann, and I realize about the way in which Synagis affects those who receive it.....I guess I should have been more specific to say that neither of my boys has ever been KNOWN to have it, and when/if they did, it wasn't a bad case at all and didn't require hospitalization, etc. My niece had it at age 2 months (not a former preemie) and she ended up in the hospital, so I certainly know that it can be serious even for full-term babies.

Bottom line, I'm glad to have it and have felt fortunate for whatever protection it has provided us.

Re : Synagis shots....

Posted: Tue Jan 03, 2006 12:20 am
by season
Just an FYI, (not a doctor) the Synagis shot does not keep a child from contracting RSV. It lessens the effects of the illness if they do catch it. That's why preemies receive the shot, because often their lungs are weaker and would be mroe greatly effected byt the illness.

Most kids get RSV by the age of 3, but also don't realize they had anything mroe than a bad cold. So Jen, it's possibel your boys have had RSV, but due to synagis or jsut being bigger and healthier (or both) you did nto realize it.

Most insurance companies do cover it, because they understand that a hospitalized child costs a lot more than the shot. Although maybe each company ahs a different criteria for who they feel will benefit from the shot.

I know my ds, 34 weeker, did not receive Synagis. Apparently older preemies do not always qualify.

Re : Synagis shots....

Posted: Tue Jan 03, 2006 11:12 am
by jenandtheboys
Betsy, great idea for doing something to encourage/force insurance companies to cover Synagis............although at this moment I don't have any fabulous ideas as to how to go about it.

We are lucky that our insurance does cover it too, like yours, minus deductible and the 20% share we pay after that. My oldest got Synagis his first winter (2001-02) and now we are on our second time around with Ethan....thankfully this will be the last year that he needs them, and BTW the shots have certainly worked for us b/c neither of my sons has ever had RSV (the sound you hear is knocking on wood).

I think the cost that we are being charged is higher than what you mentioned b/c Ethan is bigger and older than your least that's my interpretation. It cost around $1300 for us last year, like you said, but now we're up to $2550 a pop!!! [:0] So, our 20% will be $510, if I've done my math right! [xx(] It is inconceivable to me that this medication can possibly cost that much. I know that I'm not in the pharmaceutical industry and don't know the ins and outs of that, but I still just can't see (or two) syringes of medication costing over $2000?

I would certainly love to be involved in any campaign to raise awareness of the need for Synagis, or even more so, the need of PREEMIES to be protected from RSV. If I come up with a brilliant idea I'll come back and share, but please keep going with your efforts and this thread. Maybe someone else will have the idea that kick-starts it all! THanks!

Synagis shots....

Posted: Tue Jan 03, 2006 10:35 am
by onfaith
just wanted to post to find more info regarding synagis shots for RSV. I have researched as much as possible and talked to specialists to understand this drug and it's need. What is upsetting to me, is the lack of interest in it to insurance companies. I have spoken to three different companies, one of which does not cover the cost at all....each shot is close to $1300.00 a pop...fortunately, our insurance does cover this minus the deductable and co-pay....I am hoping to find someone that may know something about getting the need for this passed on to insurance companies, to force them to cover this. There are too many stories of families who can not afford this shot...and the possible ramifications of this is too severe in my opinion. No the shot is not 100%, but in the season that has's better than nothing. Any ideas on where to start with this????