When you are getting ready to do IVF, your fertility clinic should be able to give you a price list of all of the services and procedures they anticipate you will need, allowing you to figure out the cost of the clinic side of your cycle fairly easily. These rates are fairly predictable across the US, a little more expensive in big cities with higher costs of living, not so bad in the heartland, but overall fairly similar.
Where a cycle can get outrageously and surprisingly expensive is the price of the meds for your treatment. This can typically cost anywhere from $1000 to more than $4000, depending on factors like age, hormone profile, conditions... you get the picture.
In typical Hodge fashion, Ethan and I decided that we wanted to shop around for our medications. Since we had plenty of advance notice of our cycle, we got my prescription list and set to work finding the best, safest, least-expensive way to get our hands on these medications. I thought I'd share what we learned with y'all, so you can mitigate the cost of this insanely-expensive method of baby-making :-)
Most fertility drugs are made under multiple brand names, and you want to be able to research the price for ALL of these brands. They're all interchangeable (within the generic, of course), and the price can vary drastically. You'll see what I mean in a minute :-)
Local pharmacies, even big names like CVS and Walgreens, do not sell enough fertility drugs to buy in bulk. If, by some miracle, they have what you need in the quantity you need it, the prices will be pretty high because they have not been able to order it in bulk. If not, they'd have to order it anyway, and you still pay more and still wouldn't get it that day.
My clinic highly recommends IVFmeds, and I trust their recommendation. They are not US-based, so your US clinics may not even mention them to you. They are based in London, England - which, incidently, is where the first IVF procedures were done. The Brits have been doing this even longer than we have, trust them. :-) We are getting some of my drugs from this company, and some from Freedom Fertility Pharmacy, but that's another later point.
Some of the big name fertility drug manufacturers have programs you can apply for that can potentially give you deep discounts on their products, especially if you are 100% self-pay (as many - if not most - fertility patients are). Serono, who is the maker of Gonal-F (a brand name of FSH - follicle stimulating hormone) calls their program "Compassionate Care," and if you're approved, the LOWEST discount is 50% off. Follistim is an identical product to Gonal-F, and their program is called "First Steps." They give discounts of between 5% and 75% off. There are some strings attached to programs like these, mainly that you cannot use them at every pharmacy out there, but they are worth looking into! Serono even has similar programs for people who DO have fertility medication coverage, too! Go ahead and apply for any of these programs you may qualify for, and choose the brand that will give you the best deal. (Gonal-F and Follistim are one of the instances of the same drug under different, completely interchangeable names.)
I made a table in Word, with all of the medications I needed down the side, and all of the different options we had for purchasing them across the top. The two pharmacies I was comparing specifically were Freedom Fertility and IVFmeds. For everything I needed, the base price at IVFmeds was cheaper. But wait! We qualified for a 25% discount from Follistim, and a 50% discount from Serono. And it just so happens, Serono makes two of the other drugs I need. And it also just so happens that IVFmeds cannot accept the Serono Compassionate Care card. So for non-Serono drugs, IVFmeds was my less expensive option, but Freedom Fertility was the better option for my three Serono drugs (Gonal-F, Ovidrel and Cetrotide).
Another issue for my table was the variation in price for different brands. One drug I will be on is HMG. Brand names for it are Repronex, Menopur, and Merional, but IVFmeds even carries a generic version (but they do not carry Repronex). I need 11 vials, and the prices per vial of the versions they do carry are: Menopur: $56, Merional: $40, and generic: $25. The catch on the generic is that it is an intramuscular (IM) injection, which are a little more difficult and painful than sub-cutaneous (sub-q). I opted for the Merional, but it was out of stock until next month... so I could choose from the Menopur (at $616 total) or generic ($275). I chose the generic... that's a savings of $341, or about 55%. We can learn to give an IM shot for that! If I had gotten it through Freedom Fertility, my total cost for that ONE medication would have been... drumroll... $1538.90. So by choosing the generic from IVFmeds instead of Repronex from Freedom Fertility, we saved $1263.90, or about 82%. I do have to pay shipping from IVFmeds, but it is only about $50. Considering the $1500 or so they're saving me, I'm fine with that ;-)
I am extremely lucky to be working with Anna at BFC, because she is a communicating ROCK STAR, and makes this step easy! Several weeks ago, she sent me my prescription list. When I had done all of the shopping (and had run questions like the Menopur/Merional/generic stuff past her), I asked her to send me two separate prescriptions: one with the medications I was getting from IVFmeds to send to them, and one with the medications I needed to get from Freedom Fertility. **This will not be a concern unless you are pursuing IVF overseas like we are, but... Freedom only accepts prescriptions from doctors licensed in the US. If your doctor is not (mine isn't), you will need to coordinate with a doctor here. You're going to need them to do a baseline ultrasound, prescribe your birth control, and possibly order lab tests for you, too, so hopefully you have a good enough working relationship with them that they'll fax a prescription for what you need to a US pharmacy if you ask them.**
**I hate that I have to add this part, a week after drafting the post**
The drugs I ordered from IVFmeds are stuck in customs. According to USPS, they've been in New York for almost a week, and IVFmeds is sending a replacement order with rush shipping, HOPING one of them gets to me on time. This is definitely a risk you run ordering from overseas. My advice - learn from my experience, and make them ship early. Mine left London on June 11, even though I ordered on May 30, for injections starting June 24. I wish I'd told them to send them straight away. Better to have to store them for a few weeks than be bawling your eyes out on birth control hormones because they're delayed in customs!!!
**Adding again: June 21, 2014**
My meds left London on June 11, reached customs in New York on June 13. On June 20, at 9:45am, they cleared customs. By 11am the next day, the mailman brought them to my door! In plenty of time to start my cycle. DEFINITELY order early, and ask them to ship right away!
**Edit: January 23, 2015**
Due to a recent explosion on Pinterest, I'm popping back in again to review and revise this post. Since writing it, we finished the cycle we were preparing for and also did an FET (frozen embryo transfer). We learned one more valuable tip during that second cycle that I wanted to share :-) When pricing medications at local/brick-and-mortar pharmacies, check out programs like GoodRx and LowestMed. You can search by medication/dose, and it will locate the lowest price near your ZIP code. That price is usually contingent on using their coupons, which can be printed or screenshot, and look just like insurance information (BIN, PCN, etc). Your pharmacy will need to run them like insurance, and will appreciate if you give them the info before pick-up. For our FET cycle, we were able to get all of our medications locally, using three different pharmacies (Target, CVS, and maybe Meijer?). For both my Lupron and my progesterone-in-oil, we saved several hundred dollars using just the GoodRx app. I didn't keep the records of my price hunt for that cycle, so I can't give exact figures, but it is very worth checking out! Add that as a column in the table we talked about above :-)
If you're new here, please check out our story of doing IVF with Barbados Fertility Centre. We are so incredibly grateful to be expecting twins, thanks to the incomparable Dr. Skinner and her wonderful team!! I truly believe that their supportive nature and focus on our total wellbeing (and relaxation) made a huge difference in our success :-)