A member with lung cancer was treated with IV Etoposide. Through our involvement and discussion with the provider and family we transitioned the individual to an equally effective oral
Etoposide. Neulasta was arranged to be given in the home at the appropriate timing maximizing
the drug’s efficacy. This drug was given to help limit hospitalizations related to neutropenia.
The patient was directed to in-network providers, saving the plan 32% of billed charges.
The change to oral chemo avoided pharmacy costs and administration costs, yielding savings per day of $532; two days per cycle; saving $1,064 x 10 cycles = $10,640
- Direction to in-network facilities for appointments and treatments yielded savings of $1,000
- Self-administration of medication yielded savings of $50 per visit; 10 visits avoided = $500 saved;
- Estimated two-day hospitalization avoided with increased efficacy of Neulasta, at $2,700/day at primary network rate for hospitalization. Cost Avoided = $5,400
The result was total savings of $19,740 with increased quality of life for the patient.