I'm not sure who reads our blog these days so if the following rant offends you, I can't say that I'm sorry but I'll warn you that it's a rant about my uterus and insurance companies and greed!
Cooper was born at 34.5 weeks gestation. He was considered a late term preemie but he had respiratory distress as most of you know and spent about 10 days in the NICU. Fortunately, he's grown to be a perfectly healthy little boy with no lingering effects. When I was pregnant with Cooper I paid $0 in prenatal care with the insurance that I had. When he was in the NICU, his total bill came to a whopping $50,000.00. Yes, that says 50k! We didn't have to pay a dime because our insurance covered all of it. Yes, we were lucky in many ways.
Fast forward just 3 short years and its as though it's been 20 years since I had a baby in terms of insurance and coverage. I now have deductibles and coinsurance and much less coverage this time around even though I'm with the same insurance company under the same plan. To get my prenatal care and give birth I can expect to pay around 2k out of pocket. That feels harsh, but doable, and it was an anticipated cost when we were planning for baby #2. We're lucky we can plan for that type of cost!
All of this was acceptable, things change, times are different. But with this pregnancy my doctor wanted me to get a progesterone shot beginning at 16 weeks through my 36th week that would significantly decrease the odds of my having premature labor again. Since there was no known cause for my premature labor and after one preemie you are at an even higher risk for another preemie I was the perfect candidate for this treatment. I started my weekly shot at 16 weeks as scheduled. I've had 11 of these shots to date. Enter KV Pharmaceutical.
A couple of weeks ago I happened on an article on msnbc.com about a premature labor drug spiking from $10 to $1500 per shot. This is my shot, that was covered by my insurance company, with no problem. KV Pharmaceutical won government approval to exclusively sell "Makena", the new name of my progresterone shot. Originally their suit was backed by the March of Dimes and by OB's because it meant the quality would be more consistent and would be easier to get. They did not anticipate the greed, which quite frankly, surprises me. Isn't that what these companies do? Make a crap load of money off of people who need their drugs? To me, not so shocking! Everything was fine for my shots for the last couple of weeks, and then I needed a refill. Now, pre authorizations aren't working, approvals aren't being made and now at 28 weeks I'm skipping a shot. If I'm lucky, I'll get approved in time to get a shot next week. If I'm lucky, I'll get approval period. And if I'm super lucky, my baby will be full term. If I don't get any more shots I'm hoping that I've had enough to keep my levels up so I won't have preterm labor.
Steve and I have talked about the long term vision of our family. Baby #3 seemed like it was unlikely, but isn't that our decision to make? If I can't get those shots then would I want to risk another preterm labor? Why does KV get to call the shots on the state of my uterus? My uterus is none of your business!
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