If Regranex Was A Drug, I'd Sell It By The Gram

I recently started a new phase of treatment for my pressure sore. As the IV antibiotics I've been infusing to fight my osteomyelitis infection now seems to be doing the trick, my doctor prescribed for me to have a medication called Regranex applied to the wound once a day. Regranex is a special gel used in the treatment of pressure sores. The active ingredient is a growth hormone designed to encourage macrophage production and enhance tissue growth (although I'm still not hitting the long ball as I would like). Essentially, it mimics the body's own ability to promote wound healing. 

This treatment is necessary because after my initial surgery to clean out the sore and have a bone biopsy performed, the cavity of the sore was left wide open. Simply closing the wound up at that point in time would have been counterproductive because, not only did the infection remain in the ischial bone beneath the wound, but without any tissue covering the exposed bone, closing the wound over would have left me with a potential sink hole of sorts in that same spot. The skin in that area even more susceptible to breakdown than before the sore occurred in the first place. In order for the wound to finally heal properly it must fill in from the inside out. The Regranex is supposed to aid in the tissue growth to complete that process.

What makes the Regranex an interesting medication, in the context of the various aspects of my medical care, is its cost. Each tube of Regranex is measured out at 15 grams. Pharmacies will not stock Regranex, even though it is dosed in such small quantities, because that 15 gm tube is sold at an average price of over $520 according to some Internet sleuthing I performed. Suddenly, the insurance change that increased my co-pays from $5 to $10 doesn't seem like such a big deal. Per dose that checks in at a sum of approximately $38 per gram. I thought that sounded kind of expensive, but just how expensive? What else costs about $38 a gram?

Well, gold is highly valuable in some circles. On a recent day gold was trading for $801 per ounce and one once is equal to 28.3 grams. Do a little arithmetic and we find that gold trades for just over $28 a gram—score a point for Regranex. Oil is getting a lot of press these days; something about it being a limited resource by which the Western world fuels itself. When I last checked oil traded at about $94 a barrel. Now oil isn't actually sold in barrels, but as a unit of measure the size of a barrel of crude oil is 42 U.S. gallons. If that barrel was full of water it would weigh almost 350 pounds. Sixteen ounces to a pound, 28 grams to an ounce; a tube of Regranex approximately the size of a barrel of oil would sell for over $5.9 million, although I suspect in such a quantity Walgreen's might cut me a bulk rate deal.

What about illicit drugs? I've heard illegal drugs are quite expensive. According to Wikipedia cocaine can be bought for between $30-$120 a gram. The farther down the chain you are, apparently the more expensive cocaine becomes. I guess when it comes to blow, it's all about who you know (caveat emptor: find out how many times your coke has been cut, but be subtle about it). Drugs are bad, m'kay, but let me just mention that I found myself a little disappointed by the fact I had to refer to Wikipedia to find out my cocaine information. It's like having to look up how to launder money in the dictionary—not the best way to confirm one's street credibility. I don't know how this happened either. I'm not saying I have any inclination to know or associate with cocaine users or dealers, but I went to college, I know people who lived in fraternity houses, I have even used the bathroom in a Miami nightclub; the price of an eight ball is just experiential knowledge I feel I should have gained somewhere along the way. I saw Traffic—this never would have happened had I grown up in West Bloomfield. 

I have three refills on this prescription too, if there was a better market for its healing powers I should be able trade my three tubes of Regranex for something cool or useful, like an RPG, but I digress. I'm sure there are other, more relevant products I could use to provide a better cost analysis comparison to belabor this point, but I got lazy. I present this information to simply illustrate the fact that Regranex is expensive.

Oh, and to the FBI agents monitoring my recent web searches: I'm not really looking to buy cocaine or a RPG. Just wanted to clear that up. Thanks.

Word to your mother.

No Payment Due...That's Nice.

The bill for my hospital stay came in the mail sometime last week. I've been through this enough times that I'm no longer surprised at how much medical procedures cost, but I do still find it interesting at how much my insurance is charged for various aspects of my care. Case in point, here is page two of the bill for my pressure sore surgery:

(click to enlarge)

I kind of got a kick out of the fact that there are two different rates for the time spent in surgery. The first 30 minutes are apparently billed at a set amount of $1396, and then each subsequent minute is billed in addition to that. I now know that I was in the operating room for a total of 98 minutes. The additional 68 minutes clocked in at $2108, which by my calculations breaks down to $31 per minute. That initial half-hour, on a per minute basis, comes in at $45 and some change. Damn, I didn't know I was getting a discount.

Well hey, as long as this thing is on sale is there anything else you guys can patch up? I took a broomball stick across the bridge of my nose my freshman year and my nose just hasn't been the same since. It's not that noticeable, I know, but there's a bump there on the right side...No, no my right...that wasn't there before. Can you clean that up? I mean, this is plastic surgery. Right?

The moral of the story is, if you only have half an hour on your schedule to squeeze that next operation in, it's going to cost you more to come back and have them finish up later. Might as well bite the bullet and be late to that next appointment.