Baclofen pump FAQ

[MSspouse]

...Again depends on your cpverage. Who is your insurance case manager? ...

As stated, just straight Medicare part A & B. I've never heard of a case manager for Medicare. Probably not a bad idea to go straight to Medtronic but I would think there is a standard cost allowed for this procedure from which the Medicare copay/deductible can be calculated.

[sjean423]

I'd consider the trial just to know if it's even worth considering.

I don't think you could even get a pump put in without the trial, so that is the place to start anyway. See if they would cover that part, and go on from there if it is effective.

[zevobru]

Before having a baclofen pump put in, I would suggest reviewing the potential side-effects of baclofen with the doctor. My son had many problems which his psychiatrist attributed to baclofen. Also talk with your physical therapist and ask if any of their patients had side-effects. Then you can balance the benefit and risks.

[quad79]

I just got my pump a few months ago & so far life is so much better! No interference with driving, sleeping, getting dressed...the list goes on.

I was taking 90mg oral & it wasn't getting many anywhere, just feeding my bodies addiction to it.

I was very surprised that the process took so long. Mr dr. sends every patient to the psychologist for testing. The do this to make sure you have realistic expectation, aren't bi-polar or schitzophrenic, or have a possible drug habit. Then there was the trial. Then the surgery. To my amazement, I was awake the entire 2hrs. under general anesthesia & a spinal block. I went home just hours later too!

It's alot to consider but if you're @ the end of your rope like I was, go for it.

[MSspouse]

So I finally called Medtronic but wasn't able to get any average cost data. After pressing the customer service rep for a way to at least research the drug refill on insurance formularies, I did learn that the form of the drug is called Intrathecal. Should have guessed that, but then again the consumer should not have to do this kind of research to get an estimate. Ironically, a few web searches including the term Intrathecal lead me to the professional section of the Medtronic web site where I found links to coding and 2012 Medicare national average prices.
http://professional.medtronic.com/pt...m#.UHY7ixx7NZ0
The prices vary greatly depending on where it is performed. Even a trial could as much as $2000 in Medicare deductible/copay if performed inpatient. We will definitely need to find Surgeon willing to do a trial outpatient or a surgery center.

[quad79]

Definitely push for an outpatient trial!

My trial was done impatient yet my actual surgery was done outpatient! I saw no reason to stay overnight after the trial anyways once my reaction was noted, especially when I was pushed out the door within five hours of having something permanently shoved in my spinal cord..wth?

Good luck!

[zevobru]

Hope the pump works out for you Quad79. Just a note that my son started out the same way. After about 6 months he became depressed was put on anti-depressents..starting a downward spiral in hsi life over the next ten years. It could be just him, but thought you might want to know what to look out for.

[Evonne]

I just got my pump a few months ago & so far life is so much better! No interference with driving, sleeping, getting dressed...the list goes on.

Hey girl,

Glad to see all is well with the pump. I hope you continue to do well with it. Good luck

Evonne

[Wills77]

I've been considering one lately and my doctor is sending me some information on them. Just dreading the look of the pump haha.
Right now I'm on 80mg of baclofen a day and 2mg of valium before bed. I'm prescribed 4 valiums a day as needed for spasms but they make me way too tired to even function so I only take that one before bed.
After I do my FES bike and my legs are loose it makes everything soo much easier.

[TINAMARIE]

So I finally called Medtronic but wasn't able to get any average cost data. After pressing the customer service rep for a way to at least research the drug refill on insurance formularies, I did learn that the form of the drug is called Intrathecal. Should have guessed that, but then again the consumer should not have to do this kind of research to get an estimate. Ironically, a few web searches including the term Intrathecal lead me to the professional section of the Medtronic web site where I found links to coding and 2012 Medicare national average prices.
http://professional.medtronic.com/pt...m#.UHY7ixx7NZ0
The prices vary greatly depending on where it is performed. Even a trial could as much as $2000 in Medicare deductible/copay if performed inpatient. We will definitely need to find Surgeon willing to do a trial outpatient or a surgery center.

If you are looking for the cost of a baclofen pump refill, mine was $2288.00 NOT including the doctor's fees. I have a copy of a bill from University of Michigan right here in front of me and it reads like this:


Refill/Maintain Implant Pump - $ 306
Electronic Anal Pump W/Repr $ 517
Lidocaine 2% 20ml Inj $ 9
Baclof 10mg/20ml Kit IT Inj (qty of 2) $1,456

[rybread]

I got my baclofen pump replaced last week. So far so good, no infections yet. This is my fourth one. We didn't have to change the catheter so all is well. Hopefully I stay infection free since I didn't have time to catheter chains and I have no dressing on my back.

[allenstevens]

Does anyone have a pic of what the pump looks like under the skin? just curious

[MSspouse]

If you are looking for the cost of a baclofen pump refill, mine was $2288.00 NOT including the doctor's fees. I have a copy of a bill from University of Michigan right here in front of me and it reads like this:


Refill/Maintain Implant Pump - $ 306
Electronic Anal Pump W/Repr $ 517
Lidocaine 2% 20ml Inj $ 9
Baclof 10mg/20ml Kit IT Inj (qty of 2) $1,456

Thanks for the info. Is that what is billed to Medicare/Insurance? I'm curious what is actually paid by Medicare and what copay category (e.g. 20% copay) it falls under.
I called the Physiatrist office and she was helpful but not very definitive. She seemed to think it would be about $180 copay with Medicare. That's not so bad. We can handle low hundreds, but not thousands every year.

[new dimension]

pump date set..

Well the trial went well other then a horrendous spinal headache andi lightheadedness. Is that typical and can we expect the same when the pump is implanted?

[McDuff]

That is typical for the test run, large amount of spinal fluid replacement doesn't play well with the head. The pump outputs a much smaller and constant amount of med, and there is no fluid withdrawal, so the "headache bounce" should not happen. At least did not for me.