Dermatoligists questions? ( feeling ripped off!! )

johnzer6889

So. went to my GP a mont ago, and was given an appointment, went today ( went private ) cost E120, that was alright, we decided that i needed to go on rauccotine, ( has to be monitored regularly ). so anyway, before start I have to get a blood test, test if my liver is strong enough ( she should have informed this before the appointment, first E 120 gone ) Then, i'll go back in a weeks time another E 120, now i'll be on it for six months, She says i'll have to return once a month for six months. Then blood tests every month. Final cost

7 X 120 = 840
6 X 50= 300 ( medication )
6 X 30= 150
Total = 1290
then the expense of going up every month 1 1/2 hour drive

So am I being ripped off, is every dermatoligist like this???? It annoys me because the doctor cant give this medication! any advice is welcome please

youngblood

having been there, it sounds about right,
the prices a few years ago for roaccutane were much much higher!

johnzer6889

youngblood wrote: »

having been there, it sounds about right,
the prices a few years ago for roaccutane were much much higher!

Did you have to go through the rig ma roll of going up to her every month and get your bloods tested?? thanks for replying!!

SusieBlue

I was on it for a short period of time and yes, I had to go back for bloods. My doctor also insisted on a monthly pregnancy test as well as the bloods, which was done on the same day as the bloods.

youngblood

If your female they will prob do a pregnancy test too,
Yea every month, the tablets are very harsh on the body so much so
they can cause liver damage, these monthly blood tests are vital to see that it doesnt happen-
its costly but results are worth it, trust me

johnzer6889

youngblood wrote: »

If your female they will prob do a pregnancy test too,
Yea every month, the tablets are very harsh on the body so much so
they can cause liver damage, these monthly blood tests are vital to see that it doesnt happen-
its costly but results are worth it, trust me

So, you dont think im being ripped off?

Stheno

Not necessarily, given the care you are getting, I pay €150 for a "new" consultation for my surgeon if I need to see him after a period, then .......€80 per repeat visit.

Did your dermatologist tell you each visit is €120? Sometimes they reduce it for repeats?

youngblood

Unfortunately no,
its a hugely expensive undertaking but the prices are average from what I hear these days, I paid nearly twice your amount for the same medication a good few years ago so in fact it seems v reasonable to me!
I would imagine you wont be charged full whack for each blood test though so thats a few euros saved

johnzer6889

Stheno wrote: »

Not necessarily, given the care you are getting, I pay €150 for a "new" consultation for my surgeon if I need to see him after a period, then .......€80 per repeat visit.

Did your dermatologist tell you each visit is €120? Sometimes they reduce it for repeats?

No, but the next day I will ask her! em well im not sure about the price of rauccotine, but i know it cant go over E132 a month, so thats not to bad, did your acne come back?

Stheno

johnzer6889 wrote: »

No, but the next day I will ask her! em well im not sure about the price of rauccotine, but i know it cant go over E132 a month, so thats not to bad, did your acne come back?

I don't have acne, I was comparing it to visits I make in relation to a knee problem.

However I've four friends who used it for treatment, and it didn't come back in all four cases

Best of luck with it!

Brewie

I was on the stuff for 18 mths for 2 big permenant red circles under each eye/cheek area. I was going to a consultant in Glasnevin for it about 6 years ago. The stuff definitely worked but had horrible side effects. The marks never returned. Seriously flackey skin (dried skin) and permenantly dried lips for the 18 mths.

Appointments were €160 a pop (every appointment) for 5 minutes with him - Literally was "how are you feeling?", "let me have a look" & heres your perscription. First 6 months were monthly appointments. After that I had bi-monthly appointments.

Blood Tests were monthly for the first six months and then every four months for the last 12 mths.

I dont know the costs of the medication itself because I wa only €15 euro under the max total amount for medication payable ie anything over the €130 is mark was "free" and I was paying €115 anyway so I can't help you there.

The stuff works but I found the dry facial skin & lips absolutely horrible for the 18 mths.

youngblood

Never as bad as it originally was!
(perfection compared to what it was!)

Clearlier

johnzer6889 wrote: »

So. went to my GP a mont ago, and was given an appointment, went today ( went private ) cost E120, that was alright, we decided that i needed to go on rauccotine, ( has to be monitored regularly ). so anyway, before start I have to get a blood test, test if my liver is strong enough ( she should have informed this before the appointment, first E 120 gone ) Then, i'll go back in a weeks time another E 120, now i'll be on it for six months, She says i'll have to return once a month for six months. Then blood tests every month. Final cost

7 X 120 = 840
6 X 50= 300 ( medication )
6 X 30= 150
Total = 1290
then the expense of going up every month 1 1/2 hour drive

So am I being ripped off, is every dermatoligist like this???? It annoys me because the doctor cant give this medication! any advice is welcome please

Think you'll find that 6 x 30 is 180 rather than 150.

Roaccutane is a strong and potentially very nasty medication that I personally wish I'd never taken. I'd advise doing your own research before making a final decision on it. If you do take it then you want to be in the care of a dermatologist who should know what to look out for. The majority of people that I know who have taken it have been more or less fine but in what seems like a cursory consultation a good dermatologist is looking for a few things. The 'How are you?' won't be a throwaway line no matter how it's delivered.

The cost of medical care is a competely different question to whether you need it or not. It all seems expensive to me.

Drained_Empty

Howya Johnzer

I appreciate the fact you're investigating whether this is standard practice or you're being taken for a ride. Can I just reiterate a few things for you. You are seeing a consultant dermatologist for an acne problem that didn't respond to previous treatments. She has decided a 6 month course of Roaccutane (isotretinoin) is indicated. This drug can be damaging to the liver and some say, has the potential to induce suicide ideation amongst people predisposed to depression.

In other words, it can damage you liver and potentially cause psychological change.

As a result you need to be monitored on a regular basis for blood tests that assess the functioning of your liver and be screened for depression or suicidal ideation. In other words, the Dermatologist wants to see you after the first week, then every month, to take a blood sample and ask you questions about your mental health.

Isotretinoin can only be prescribed by consultant dermatologists in this country (and the UK). GPs can't prescribe it, Hospital doctors can't prescribe it, only a dermatologist.

Now you are due to see her next week, what you should explain is that money is tight (as it is for almost everyone) and due to the transit time ask

Can your GP monitor bloods etc. instead of the dermatologist. REasonable request in my opinion but she may not agree because there are other matters we don't know about (maybe she wants to physically see you to monitor your acne improvement).

If not, what exactly is the repeat consultation fee etc.?

Just to put this in context, it costs circa 50 euro to see a GP in this country without a medical card. It costs circa 50 euro for a personal training session with someone who got their qualifications off Kelloggs. Its costs circa 50 quid to get your hair done in some places.

A consultant dermatologist has ~5 years of medical school, and about ~10 years of post-graduate education and training. It costs literally millions of euro to train a consultant from medical school entrance to consultant. PAid for by the state, the EU, the person themselves and this money needs to be recouped.

In summary, you're right to see if you can reduce the cost but no, imo, you're not getting ripped off.

johnzer6889

Clearlier wrote: »

Think you'll find that 6 x 30 is 180 rather than 150.

Roaccutane is a strong and potentially very nasty medication that I personally wish I'd never taken. I'd advise doing your own research before making a final decision on it. If you do take it then you want to be in the care of a dermatologist who should know what to look out for. The majority of people that I know who have taken it have been more or less fine but in what seems like a cursory consultation a good dermatologist is looking for a few things. The 'How are you?' won't be a throwaway line no matter how it's delivered.

The cost of medical care is a competely different question to whether you need it or not. It all seems expensive to me.

Woopsies my excellent maths skills!! I went into the doctor yesterday, seemly thats the procedure, if thats what it costs, It'll be worth it!

johnzer6889

Drained_Empty wrote: »

Howya Johnzer

I appreciate the fact you're investigating whether this is standard practice or you're being taken for a ride. Can I just reiterate a few things for you. You are seeing a consultant dermatologist for an acne problem that didn't respond to previous treatments. She has decided a 6 month course of Roaccutane (isotretinoin) is indicated. This drug can be damaging to the liver and some say, has the potential to induce suicide ideation amongst people predisposed to depression.

In other words, it can damage you liver and potentially cause psychological change.

As a result you need to be monitored on a regular basis for blood tests that assess the functioning of your liver and be screened for depression or suicidal ideation. In other words, the Dermatologist wants to see you after the first week, then every month, to take a blood sample and ask you questions about your mental health.

Isotretinoin can only be prescribed by consultant dermatologists in this country (and the UK). GPs can't prescribe it, Hospital doctors can't prescribe it, only a dermatologist.

Now you are due to see her next week, what you should explain is that money is tight (as it is for almost everyone) and due to the transit time ask

Can your GP monitor bloods etc. instead of the dermatologist. REasonable request in my opinion but she may not agree because there are other matters we don't know about (maybe she wants to physically see you to monitor your acne improvement).

If not, what exactly is the repeat consultation fee etc.?

Just to put this in context, it costs circa 50 euro to see a GP in this country without a medical card. It costs circa 50 euro for a personal training session with someone who got their qualifications off Kelloggs. Its costs circa 50 quid to get your hair done in some places.

A consultant dermatologist has ~5 years of medical school, and about ~10 years of post-graduate education and training. It costs literally millions of euro to train a consultant from medical school entrance to consultant. PAid for by the state, the EU, the person themselves and this money needs to be recouped.

In summary, you're right to see if you can reduce the cost but no, imo, you're not getting ripped off.

Thanks for replying, summed it nicely there, the nurse will be monitoring my blood every month, so I its not too bad, it's just my man and I taught it was going to be two appointments, mam doesn't mind spending the money if its worthwhile, its just that, it be a shame to be codded out of a few hundred euro! Never does no harm to hear from other peoples points of views, i'd like to get it before it starts to scar! Thanks very much for writing such a detailed reply, really appreciate it!! :P

johnzer6889

Brewie wrote: »

I was on the stuff for 18 mths for 2 big permenant red circles under each eye/cheek area. I was going to a consultant in Glasnevin for it about 6 years ago. The stuff definitely worked but had horrible side effects. The marks never returned. Seriously flackey skin (dried skin) and permenantly dried lips for the 18 mths.

Appointments were €160 a pop (every appointment) for 5 minutes with him - Literally was "how are you feeling?", "let me have a look" & heres your perscription. First 6 months were monthly appointments. After that I had bi-monthly appointments.

Blood Tests were monthly for the first six months and then every four months for the last 12 mths.

I dont know the costs of the medication itself because I wa only €15 euro under the max total amount for medication payable ie anything over the €130 is mark was "free" and I was paying €115 anyway so I can't help you there.

The stuff works but I found the dry facial skin & lips absolutely horrible for the 18 mths.

18 months, yikes you had it hard! I'd say it paid off though, did you notice any of the side effects? Thanks for replying a great reply, appreciate it! :P