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Lupus Treatment Cost


How Much Does Lupus Treatment Cost?

 
average costWith Health Insurance: 10%-50% Coinsurance and Copayshigh costWithout Insurance: $1,000-$35,000+ a Year, Depending on Treatment
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Lupus is a chronic, incurable autoimmune disease in which the body attacks itself. Symptoms vary but can include joint swelling and pain, fever, fatigue, a rash on the face, headaches, dry eyes, shortness of breath and chest pain. Lupus can be treated with medications.

Typical costs:

  • For patients covered by health insurance, out-of-pocket costs for lupus treatment typically consist of doctor visit, lab and prescription drug copays of 10%-50%. Lupus treatment typically is covered by health insurance, although individual drugs or treatments might not be covered by some plans.
  • For patients not covered by health insurance, lupus treatment can cost from less than $1,000 per year for corticosteroids to more than $35,000 for newer biologic treatments. For example, DrugsDepot.com charges less than $20 for a one-month supply of the generic corticosteroid prednisone. DrugsDepot.com charges $30 to -$50 or more for a one-month supply of the generic anti-malarial drug hydroxychloroquine sulfate, or $350 to -$500 or more, depending on the dose, for a one-month supply of the brand-name version Plaquenil. A new treatment for lupus, given through IV infusion, Benlysta[1] costs about $35,000 per year, according to the National Institutes of Health.
  • According to a fact sheet[2] from the Lupus Foundation of America, the yearly cost of treatment for lupus averages more than $12,600 per patient. In patients with lupus nephritis, in which kidneys are involved, the annual costs[3] range from just under slightly less than $30,000 to over more than $60,000 a year, according to LupusResearch.org.
Related articles: Blood Tests, Genetic Consultation

What should be included:
  • A doctor typically will prescribe medications to treat lupus based on the individual case and specific symptoms. The most common type of lupus[4] is systemic lupus erythematosus (SLE), which can affect many areas of the body
  • Over-the-counter anti-inflammatory drugs, such as aspirin and ibuprofen, can be used to reduce pain and fever.
  • Medications approved by the U.S. Food and Drug Administration to treat lupus include: corticosteroids such as prednisone, prednisolone and hydrocortisone. The anti-malarial drug hydroxychloroquine[5] (brand name Plaquenil) also is FDA-approved for lupus. And the brand-name drug Benlysta[6] , a monoclonal antibody therapy, also is approved for treatment of lupus.
  • Doctors might also prescribe other drugs that have not been FDA-approved specifically for lupus.
  • The Lupus Foundation of America offers a primer on lupus treatment[7] .
Additional costs:
  • Certain types of lupus are associated with photosensitivity[8] . Patients typically need to use a broad-spectrum sunscreen and possibly install UV-blocking films on windows of the car and/or home. Most window films for the home[9] cost $6 to $15 per square foot, installed.
  • Women with lupus have a greater chance of having a child with lupus. A genetic consultation to discuss risk can cost $150 or more per hour.
Discounts:
  • Some drug companies offer free or discounted medications for patients who qualify. For example, the copay assistance program for Benlysta[10] will pay out-of-pocket costs up to $9,000 a year.
  • Patients can search for clinical trials[11] through the Lupus Foundation of America.
Shopping for lupus treatment:
  • Patients with lupus should be treated by a rheumatologist[12] , a doctor who treats rheumatic diseases, which are complex conditions that can affect the joints, bones and organs. The American College of Rheumatology[13] offers a rheumatologist locator. A rheumatologist is an internal medicine doctor with additional training, and should be board-certified in rheumatology by the American Board of Internal Medicine[14] .
  • If a patient's organs have been affected by lupus, care from another specialist, such as a cardiologist, neurologist, dermatologist or gastroenterologist might be required. A rheumatologist can provide a referral. Or, the American Medical Association offers a doctor finder[15] with the option to search by specialty.
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
 
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What People Are Paying - Recent Comments
Cost of Treating Lupus in Kentucky
Amount: $900,000.00
Posted by: Dr A L Pinkus in unknown, KY.Posted: July 13th, 2017 04:07PM
Type of Treatment: unknownMedical Center: unknown
Insurance: Medicaid
CBS News this evening (7/13/2017) presented a report of a woman in KY having to pay over $900,000 for drugs related to her lupus condition, and how she would be in jeopardy if funding for Medicaid were cut. Is this number reasonable? Is her potential treatment reasonable? Or is this just another anti-administration story? Your site shows the average annual cost as $12,600 as determined by LFA. What's up here? Who could possibly afford such an amount? How could the Medicaid system sustain such payments?
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External Resources:
  1.  www.ncbi.nlm.nih.gov/pmc/articles/PMC3351861/
  2.  www.lupus.org/webmodules/webarticlesnet/templates/new_newsroomreporters.aspx?articleid=...
  3.  www.lupusresearch.org/research/lru/assessing_cost.html
  4.  www.niams.nih.gov/Health_Info/Lupus/lupus_ff.asp
  5.  www.drugs.com/plaquenil.html
  6.  www.lupus.org/webmodules/webarticlesnet/templates/new_newsroomnews.aspx?articleid=3696&...
  7.  www.lupus.org/webmodules/webarticlesnet/templates/new_learntreating.aspx?articleid=2246...
  8.  www.lupus.org/webmodules/webarticlesnet/templates/new_aboutliving.aspx?a=94&z=16&page=1
  9.  www.scottishwindowtinting.com/window-tinting-applications/window-film-faqs/
  10.  www.benlysta.com/benlysta-facts/benlysta-gateway.html
  11.  www.searchclinicaltrials.org/clients/lupus/index.php
  12.  www.rheumatology.org/Practice/Clinical/Patients/What_is_a_Rheumatologist_/
  13.  www.rheumatology.org/directory/geo.asp
  14.  www.abim.org/about/default.aspx
  15.  extapps.ama-assn.org/doctorfinder/disclaimer.do
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