Pulmonary Embolism Treatment Cost

Typical costs:

• For patients covered by health insurance, out-of-pocket costs for a pulmonary embolism typically would include a copay or coinsurance of 10%-50%, prescription drug copays, follow-up doctor visit copays and laboratory copays. Health insurance typically covers treatment for a pulmonary embolism.
• For patients not covered by health insurance, treatment for a pulmonary embolism typically costs $15,000-$40,000 or more, depending on the length of hospital stay and whether there are complications. For example, Saint Elizabeth Regional Medical Center^[1] in Nebraska charges $12,500-$29,500 for treatment for a pulmonary embolism without major complications, depending on the individual case and length of stay, not including doctor fees. St. Mary's Hospital^[2] in Wisconsin charges about $15,000. And Baptist Memorial Health Care in Tennessee charges about $20,500 without major complications and about $37,000 with major complications, not including doctor fees. According to the American Thoracic Society^[3] , average total per-incident medical costs for pulmonary embolism are about $30,000.

• First, doctors will work to stabilize the patient and confirm diagnosis. Initial treatment might include placing the patient on a heart monitor and administering oxygen and medication to raise blood pressure.
• Typically, the blood-thinning medication heparin^[4] is administered intravenously to stop more blood clots from forming. Another blood-thinning medication, enoxaparin^[5] , might be given by subcutaneous injection. Another medication, warfarin^[6] , typically is given orally. It usually takes a few days for warfarin levels to reach an appropriate therapeutic dose. In cases in which a patient is severely ill and not responding to treatment, a drug such as urokinase^[7] might be given by injection to break up existing clots. The required hospital stay can range from two to three days to a week or longer.
• eMedicineHealth.com offers an overview of pulmonary embolism treatment^[8] .

• After discharge from the hospital, the patient typically will be placed on an anti-coagulant drug -- typically warfarin (brand name Coumadin) to help prevent blood clots. For a one-month supply, Drugstore.com charges about $15-$25 for the generic and $50-$70 for the brand name drug.
• Lovenox^[9] or Arixtra^[10] -- both injectable anti-coagulant drugs -- might be prescribed temporarily, along with warfarin, until the warfarin reaches therapeutic levels in the blood. Drugstore.com charges more than $700 for a one-month supply of Lovenox and $1,600 or more for a one-month supply of Arixtra. Insurance often covers these drugs when medically necessary, such as for patients who cannot take warfarin.
• Patients on anti-coagulant drugs require regular monitoring -- for example, for warfarin a PT (prothrombin time)/INR (international normalized ratio) test^[11] , as frequently as once per week, to make sure the drugs are working effectively. This typically costs $6-$25 per test at a doctor's office or laboratory, or can be done as a home test^[12] with the purchase of tests strips and a machine that costs $1,500-$2,500.
• Depending on the individual case, and if there is an underlying condition -- such as cancer or heart disease -- or recurrent pulmonary embolism, the patient might require extensive follow-up care and monitoring that could cost thousands, or tens of thousands, of dollars.

• Many hospitals give discounts of up to 30% or more to uninsured/cash-paying patients. For example, Washington Hospital Healthcare System^[13] in California offers a 35% discount.
• The manufacturer of the anticoagulant drug Coumadin, Bristol-Myers Squibb, participates in the Together Rx Access^[14] program, which offers discounts of 25%-40% on certain drugs. The manufacturer of Lovenox, Sanofi-Aventis, offers the drug for free to uninsured patients who qualify on a case-by-case basis, through its patient reimbursement program^[15] .

• The U.S. Department of Health and Human Services offers a hospital comparison tool^[16] that lists hospitals near a chosen zip code and whether they offer emergency services.
• A family doctor and pulmonologist -- a board-certified internal medicine^[17] doctor with additional training in lung diseases -- can provide follow-up care. Depending on the individual case, and whether there was an underlying cause, such as cancer, for the pulmonary embolism -- other specialists might be needed for ongoing care. These could include a hematologist -- a board-certified internal medicine doctor with additional training in blood disorders -- or an oncologist, cardiologist or thoracic surgeon.
• The American Medical Association offers a doctor finder^[18] by location and specialty. It is important to make sure any specialist you are considering is board-certified^[19] .

1.  www.saintelizabethonline.com/price-estimator-1.html
2.  www.wipricepoint.org/Basic_INP.aspx
3.  www.thoracic.org/education/breathing-in-america/resources/chapter-16-pulmonary-embolism...
4.  www.nlm.nih.gov/medlineplus/druginfo/meds/a682826.html
5.  www.nlm.nih.gov/medlineplus/druginfo/meds/a601210.html
6.  www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000634/
7.  www.medicinenet.com/urokinase-injection/article.htm
8.  www.emedicinehealth.com/pulmonary_embolism/page4_em.htm
9.  www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000158/
10.  healthcare.utah.edu/thrombosis/patients/Arixtra.pdf
11.  labtestsonline.org/understanding/analytes/pt/tab/test
12.  www.stoptheclot.org/News/article120.htm
13.  www.whhs.com/about/washington-hospital-discount-policy-for-uninsured/
14.  www.bms.com/products/Pages/programs.aspx
15.  www.lovenox.com/consumer/default.aspx
16.  www.medicare.gov/hospitalcompare/(S(efntd2saaeir2l5pgarwuvvg))/search.aspx?AspxAutoDete...
17.  www.abim.org/specialty/pulmonary-disease.aspx
18.  extapps.ama-assn.org/doctorfinder/disclaimer.do
19.  /www.certificationmatters.org/is-your-doctor-board-certified/search-now.aspx

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