I am a new grad RN and I feel I work in one of the best hospitals in my city. I have mostly seen equal tx of all pt's and a good majority of our pt's do not have insurance- I believe we were told about 40% of our pt's do not have insurance. Although, there have been a few situations that have really peeved me off. I would like your opinions on the following.
1) A homeless pt was subjected to a new med student putting in an IJ when a PICC was actually called for. The doc wanted her to get the experience. The student finally got it inserted on her FOURTH try and after causing a significant deal of pain for the pt and not to mention, a seizure during the third attempt.
2) Pt's that come in with illegal substances in their system do not get adequate pain control. We have many many of these pt's. We were taught over and over again in school that addicts may have built up tolerance to opiods and we should advocate for them appropriately. Doesn't seem to work with the doc's at all. I've had so many pt's that were writhing in pain and probably withrawling at the same time and only have prescriptions for a lortab or even one pt with a children's dose of pain relief. Grrrr.
3) Pt came in w/seizure and fell on rocks face first. He had a CT and urinalysis and once those were cleared he was let go with ABX and 10 tylenol 3's. This was his first seizure ever, he had a suspected broken nose, an injured shoulder from the fall... no xrays ordered, and the blood was not cleaned off his face enough before discharge to even see that a rock had pierced through his lip completely. Grrr.
So, if these pt's were known to have insurance and/or did not have illegal drugs in their systems... would they have recieved this same tx? I know I am new and don't know a lot, but come on, even I can see there is something wrong here. My offering of a warm blanket or an ice pack is not going be enough for any of these mistreated pt's.
Thanks for letting me vent and I look forward to any and all comments.
The pharmacy's cost for a full course of Xigris is about $100,000. The patient charge is 2 or 3 times that.
That, and the fact that Xigris is in itself an extremely dangerous drug to use, is why we don't drop-kick this stuff up to the ICU.
I don't know where you guys are getting you numbers but here is one source that shows the cost at about 8 thousand for the four day treatment and like I said in my prior post, the hospital where I worked charge about 3600 a bag X4 days + about 15k total cost.
Xigris, which costs about $8,000 for a four-day course of treatment, generated controversy even before federal regulators. this came from a general search on google asking how much does xigris cost, The link to the site is http://www.ahrp.org/cms/content/view/367/27/.
Cost: Drotrecogin alfa therapy is expensive with a cost of approximately $42 per mg. The average cost for a 70 kg patient is $7,000 per treatment period. The average cost for a 100 kg patient is $10,000 per treatment period. Therefore, drotrecogin alfa costs approximately $100/kg for the 96-hour treatment period.
I don't know where you guys are getting you numbers but here is one source that shows the cost at about 8 thousand for the four day treatment and like I said in my prior post, the hospital where I worked charge about 3600 a bag X4 days + about 15k total cost.
Xigris, which costs about $8,000 for a four-day course of treatment, generated controversy even before federal regulators. this came from a general search on google asking how much does xigris cost, The link to the site is http://www.ahrp.org/cms/content/view/367/27/.
I hope this puts this myth to bed. It is expensive but 100k a dose :chuckle
To clarify, I'm not talking about a single dose at $100,000; I'm talking about full treatment course for one patient (many doses over several days). Like I said, I'm hearing this from a doc - not necessarily the most trustworthy source on pricing meds...
I'll have to talk to our buyer tomorrow, but I think that the New York Times and NPR both got their facts wrong regarding the price of Xigris. It is NOT $6,800 or $8,000 for a 4-day course of treatment; it is indeed that much or more for each dose, given every 4 hours for 96 hours.
We use eMAR where I work, and when it was discovered that the ICU nurses were forgetting to chart some of them, you better believe we let them know what was going on! The patients, and their insurance companies, might like the free Xigris, but we DO have to recoup our expenses!
BTW, I can only think of one patient who got Xigris who left the hospital alive.
To clarify, I'm not talking about a single dose at $100,000; I'm talking about full treatment course for one patient (many doses over several days). Like I said, I'm hearing this from a doc - not necessarily the most trustworthy source on pricing meds...
We do indeed charge this for Gliadel wafers! That doesn't mean we get paid that much for them, of course.
to clarify, i'm not talking about a single dose at $100,000; i'm talking about full treatment course for one patient (many doses over several days). like i said, i'm hearing this from a doc - not necessarily the most trustworthy source on pricing meds...
i am not speaking about a single dose either. according to my own practical experience and what our pharmacy has stated along with the information below provided by an article on the subject by the cleveland clinic, xigris is expensive but not 100k a treatment. more like 10k a treatment. i will provide the summary and the link again. pay attention to the words treatment period and the96 hour definition of period. that means the whole treatment.
cost: drotrecogin alfa therapy is expensive with a cost of approximately $42 per mg. the average cost for a 70 kg patient is $7,000 per treatment period. the average cost for a 100 kg patient is $10,000 per treatment period. therefore, drotrecogin alfa costs approximately $100/kg for the 96-hour treatment period.
advocateforsafety
83 Posts
I don't know where you guys are getting you numbers but here is one source that shows the cost at about 8 thousand for the four day treatment and like I said in my prior post, the hospital where I worked charge about 3600 a bag X4 days + about 15k total cost.
Xigris, which costs about $8,000 for a four-day course of treatment, generated controversy even before federal regulators. this came from a general search on google asking how much does xigris cost, The link to the site is http://www.ahrp.org/cms/content/view/367/27/.
Cost: Drotrecogin alfa therapy is expensive with a cost of approximately $42 per mg. The average cost for a 70 kg patient is $7,000 per treatment period. The average cost for a 100 kg patient is $10,000 per treatment period. Therefore, drotrecogin alfa costs approximately $100/kg for the 96-hour treatment period.
http://www.clevelandclinicmeded.com/medicalpubs/pharmacy/janfeb2002/drotrecogin.htm
I hope this puts this myth to bed. It is expensive but 100k a dose :chuckle