Stretching the infertility dollar

July 14, 2010Carole 15 Comments »

When the economy is in a downturn, the birth rate declines because people put off having children in uncertain times. At least that’s been the historical trend. Postponing fertility treatments is not an appealing option if you know your biological clock is ticking, so how do you pay for it all-especially now when money is tight?

Ask your infertility doctor if he has samples of ovarian stimulation drugs. Although I think this practice is declining, pharmaceutical reps used to donate a lot of drugs to doctors to get or keep their business. Programs have different internal rules for who gets the donated drugs. Sometimes, they are held back for emergencies—like the patient who needs that extra unanticipated dose and the pharmacy is closed. It doesn’t hurt to ask. You might get a few samples to stretch your drug dollar.

Extra drugs donated to the program by patients who have finished their treatment. Pharmacies won’t accept drug  returns  so patients sometimes get stuck with extra doses of drugs. Grateful patients will sometimes return extra unopened drug to the program (or to their friends) to help someone else. Sometimes pharmacy drug plans require  30 day – or longer- scripts be filled, leaving patients with extra drug.  Cautionary note: Using donated drugs is problematic because you can’t be 100% sure that drugs were properly stored or they might be out of date, reducing their effectiveness.

Pharmaceutical discounts. Some pharmaceutical companies have programs for their fertility doctors to enroll to offer their patients “buy 2:get 1  free” drug promotions. Fertility Life Lines offers  assistance for self-pay patients .  Find out if your doctor is enrolled in the program and whether you qualify. Shop around at various pharmacies for the best prices on drugs. Ferring offers the HEART discount program. You have to pay an annual $10 membership fee but then you can get immediate discounts on Bravelle and Menopur.

You might have to shop different pharmacies for different scripts to get the best price. Also, don’t forget about mail-order pharmacies. They are usually much cheaper than your neighborhood corner pharmacy. The Infertility Resources website has a  list of pharmacies that carry fertility drugs, both inside and outside the US. Because there are no protections to US consumers when they order drugs from outside the US, even for reimportation from Canada, I can’t recommend buying reimported drugs. See my earlier post, “Can I get cheaper drugs from other countries?“.

Infertility Grants. Fertile Dreams has a Embracing Hope grant for patients that qualify. Their 2010 grant information can be found here when it starts. INCIID also offers a IVF scholarship program based on medical and financial need. Fertility Within Reach maintains a list of foundations that provide grants and other assistance to infertility patients.

Cash discounts. Some fertility clinics will offer you a cash discount if you pay cash. This option really doesn’t help you if you can’t pay cash in the first place but it is a discount offered by some providers.

Use your health insurance to the fullest extent possible. Understand your insurance plan. Even if you don’t have fertility coverage, per se, you might have a generous prescription drug coverage which may not exclude fertility drugs. You might have coverage for the diagnostic work-up or on some of the procedures even if you don’t have fertility coverage. If something is not explicitly excluded, you can often can get some coverage.

You may be lucky enough to live in a state that mandates fertility insurance –or you might consider moving to one! ASRM provides an overview of state insurance laws. Warning: Even states which mandate infertility insurance have loopholes that may allow your employer to avoid the mandate such as minimum employee number for the statute to apply. Also, some state laws exclude single women or gay couples from mandated infertility insurance coverage.

Don’t skimp on the diagnostic workup. If you identify a major problem earlier in the process, you won’t waste time and money on treatments that are unlikely to work. For instance, if your partner has no or few sperm in his ejaculate or if your tubes are blocked, it would be foolish–and expensive– to waste your time on inseminations when IVF or another surgical or medical intervention is your best option.

Make sure you fully understand the justification for trying more of the same treatment. Some programs have a set path of increasing aggressiveness for each step. For example, 3 Clomid cycles with intercourse, followed by 3 Clomid cycles with insemination, then 3 cycles of  stimulation drugs with intercourse etc etc. We occasionally saw patients for IVF after 12 cycles of other “less expensive” treatments. By the time they’d run through so many “cheaper” cycles, they could have done one IVF and been pregnant. It’s okay to ask a lot of questions to understand why your physician is recommending a particular treatment or series of treatments. If it doesn’t make sense to you, it’s okay to ask to accelerate the time line. If one provider won’t work with you, you can find another that is more compatible with your agenda. Remember, it’s your time and your money.

© 2010 – 2015, Carole. All rights reserved.

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