Previously on KDC

A couple of weeks ago I posted “Dueling Kidney Doctors” where I complained mightily about not getting a needed Epogen prescription.  Today, I’m posting the results of that battle.

Who Won?

Nobody!  I had to suffer for a month while the doctors duked it out.  My nephrologist held steady and refused to prescribe the Epogen and my urologist called it stupid! [icon name=”smile-o” class=”” unprefixed_class=””]

So, my urologist called my nephrologist, and from the accounts of each doctor’s nurse , it was a very heated discussion.  So, I told my urologist what my dosage was, and he prescribed the Epogen,

Next Battle: Insurance Co.

One battle down, next battle is the insurance company.  It turns out that you just can’t walk into the drug store and buy Epogen with your insurance, although the store is willing to sell it to you.  I had to go through the mail order specialty pharmacy because Epogen is considered a “specialty” drug.  They denied coverage for Epogen, but they would cover Procrit!  It took a week to get that sorted out, with me constantly calling the doctor’s assistant. She was a saint and did her part harassing the insurance company.

Apparently, the insurance company has a “deal” or a “contract” with the makers of Procrit, since they insisted on Procrit. Everyone says that Epogen and Procrit are the same.  Time will tell.

While the doctor’s office was fighting with the insurance company, I decided to find out what it would cost to buy either Epogen or Procrit myself. Thank God I didn’t need to buy it myself. It turns out that on the open market, Procrit is more expensive than Epogen, and they are both very expensive! A month’s worth of either varied from $1000 to $1500, and I need a 3 month prescription. Yikes!


The Procrit was delivered today, finally!!! [icon name=”smile-o” class=”” unprefixed_class=””] Thanks to the hard work and diligence of my urologist’s assistants.  All told, it has taken about 6 weeks to get the prescription. So maybe by Christmas I will actually feel like celebrating, and maybe I will no longer need the handicap pass for my car.  Then I can have my scheduled nephrectromy in January without a transfusion, and God willing, a transplant to follow!

I see the nephrologist next week for the first time since this battle began. Let’s hope he doesn’t give me a hard time.  I really don’t know what to expect, I haven’t known him long enough.

Yet another reason to advocate for yourself.