Back to Iron

Checked with another clinic regarding a home program. Also was told you would have to go in-center for IV Iron. Mentioned our nephrologist wrote a script and we did it at home. Reply was if the Dr. will write you a script you can do it at home. We just can’t give it to you so you can do it at home because we can’t get paid for iron unless we administer it. This makes me think maybe the policy is in place not so much regarding lawsuits or safety but more because of payment issues and one should check with the nephrologist about writing a script for iron to do home administration and cut down on in-center in visits if the drive is to far.

Hi Folks

Same here now , my doctor wrote a script for oral iron(niferex 150 1 a day). The center was not happy on this, there wanted to give me more iron. But I’m still have a problem with both iron and EPO. Upsets my bowels, and like clock work every night once I get to bed , I end up in the bathroom. I talked with both doctor and my nurse. I said I can’t have this, they said, your become anemia and have problems. I said I have problems now, If I can’t get good sleep due to other problem, I’ll take good sleep over the other. They said they will work on the issues.

Our DR wrote a script for venifer. I sent it in to our insurance co.
They send it to us at no cost because I give it IV to my husband.
Our center does not provide us with iron.

As some of you have found, doctors can (and some do) prescribe IV iron for patient self-administration. Medicare Part B will only pay for IV iron given in a dialysis clinic, not at home. If a doctor is willing to write a prescription for a patient to take it at home (and accept the liability if the patient has a problem with it which is low risk from what I understand) AND the patient has been trained how to self-administer to limit the risks of adverse events AND the patient can afford to pay for the IV iron or has insurance that will pay for it other than Medicare, then he/she could purchase it at the pharmacy and self-administer.

So far as Medicare coverage is concerned, currently IV iron is excluded from Medicare Part D coverage in the standard Part D plan because it is considered a vitamin or mineral and the law that created Part D excluded these drugs. The renal community has been advocating for coverage of renal vitamins, iron, etc. to be covered as essential for the health of people with kidney disease. I have not heard that this has happened yet, but hopefully IV iron companies and renal organizations will be successful in getting these classes of drugs covered just like prenatal vitamins are covered for pregnant women. I suspect it wouldn’t hurt to have patients advocating with their elected officials for this legislative change.

I am having a problem with Iron right now. My saturation is very low 12 and my clinic wants to give me Venifer. I can not handle it in my veins. My arm turns purple and the vein blows before they can finish. They say they can put it in saline and give it to me IV through my catheter. The problem here is it burns the vein too. I am taking proferrin forte which is one of the best oral irons there is today. I wish I could give the iron over the course of a eight hour treatment. I could use something like the heparin pump I use to give me small bolises of heparin through out the night. Eventualy I am going to have to go in for some Iron I guess. I just wish I didn’t have to do it this way…

LSB, I know some patients who do iron at home use the heparin pump but we don’t. We just attach the syringe to the venous med port and then inject it in very small amounts. To stay on the side of caution I usually inject .1 or .2cc every 5 minutes and it takes about an hour to administer 5ccs total.