Optum Specialty Pharmacy for HCG

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Esq

Member
I've seen a number of threads about sourcing HCG now that (hopefully only temporarily) compounding pharmacies like Empower are prohibited from manufacturing it. I just wanted to share my recent experience getting it through Optum Specialty Pharmacy.

I had my regular consult with Dr. Saya at Defy Medical a few weeks ago, and the topic of HCG came up since I'm running low on my stash of compounded from Empower. He said they have been referring patients to Optum for Pregnyl. I had to fill out one electronic form with Defy and pay them a $30 prescription call-in fee, and then Defy sent the prescription to Optum.

The process with Optum was very easy and efficient. I had to create an online account with them and provide a little medical history. About a day after the prescription was sent, Optum emailed requesting that I call to complete the order. I spent about five minutes on the phone with a gentleman in Optum's fertility department confirming my address and the order details. He let me know that the phone call was a one-time thing since it was my first order with Optum. Future orders can be done completely online.

The total cost for 10,000iu of Pregnyl was $118.90. They include a 60-day supply of syringes for free. Shipping also is free, and takes only a few days. It is a bit more expensive than Empower, which was $96.00 for 12,000iu, but shipping with Empower was a minimum of $12.00 and could be slow at times. When you factor in Defy's prescription call-in fee, it gets more expensive, but Dr. Saya included one refill so I won't have to pay that call-in fee every time.

Breaking it down, including shipping, compounded HCG from Empower came out to about about $0.009/iu, while Pregnyl through Optum, including Defy's call-in fee (50% since you pay every other time), comes out to about $0.013/iu. Definitely more expensive, but not prohibitively so, and syringes are included with Optum.
 
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Esq

Member
May be a dumb question, but does Pregnyl come lipholized and with bac. water to dilute, or is it pre-mixed when it arrives?
Your timing is impeccable. UPS just delivered it about an hour ago. It comes lyophilized with bac water separate and has to be reconstituted.

I was surprised that the included syringes are 27g 1/2". A bit heavy and long for my taste for sub-q HCG injections, but I can use them for my shallow IM testosterone injections.
 

VacationMan

Active Member
Your timing is impeccable. UPS just delivered it about an hour ago. It comes lyophilized with bac water separate and has to be reconstituted.

I was surprised that the included syringes are 27g 1/2". A bit heavy and long for my taste for sub-q HCG injections, but I can use them for my shallow IM testosterone injections.
27 gauge needles? Holy smokes! That's what I use to inject testosterone!

I use the tiny 31 gauge needles on 3/10 CC syringes for HCG. I mix it with half of the bac. water called for, so it's double strength (500 IU shot is only .25 CC this way).
 

JRos895

Active Member
I have had nothing but issues when dealing with Optum Specialty pharmacy. They always have an excuse as to why my medication cannot be filled/shipped. Perhaps it’s because my medication is covered by OptumRx and my quoted price for it is 15$ a vial so their margins aren’t so large with a customer like me.
 

Esq

Member
I have had nothing but issues when dealing with Optum Specialty pharmacy. They always have an excuse as to why my medication cannot be filled/shipped. Perhaps it’s because my medication is covered by OptumRx and my quoted price for it is 15$ a vial so their margins aren’t so large with a customer like me.
Sorry to hear that. My first experience with OSP was pretty easy and seamless, but I suppose that doesn't mean future ones will be. Were you using them for something other than HCG?
 

Gman86

Member
My experience with them was very easy and quick as well to get my Pregnyl. But I paid out of pocket like the OP. That would be pretty messed up if they couldn’t care less about orders that are covered by insurance lol
 

JRos895

Active Member
No just HCG. I honestly think it’s because I’m insured that I get such a hard time. They often try to quote me at $115 for the HCG and then I have to correct them. I think it’s because if they charge $115 they would still claim a reimbursement from OptimRx/UHC (my insurance).
These PBMs have such awful consumer practices. Congress is currently in the process of drafting a bill to curb their practices.
 

MIP1950

Active Member
I've seen a number of threads about sourcing HCG now that (hopefully only temporarily) compounding pharmacies like Empower are prohibited from manufacturing it. I just wanted to share my recent experience getting it through Optum Specialty Pharmacy.

I had my regular consult with Dr. Saya at Defy Medical a few weeks ago, and the topic of HCG came up since I'm running low on my stash of compounded from Empower. He said they have been referring patients to Optum for Pregnyl. I had to fill out one electronic form with Defy and pay them a $30 prescription call-in fee, and then Defy sent the prescription to Optum.

The process with Optum was very easy and efficient. I had to create an online account with them and provide a little medical history. About a day after the prescription was sent, Optum emailed requesting that I call to complete the order. I spent about five minutes on the phone with a gentleman in Optum's fertility department confirming my address and the order details. He let me know that the phone call was a one-time thing since it was my first order with Optum. Future orders can be done completely online.

The total cost for 10,000iu of Pregnyl was $118.90. They include a 60-day supply of syringes for free. Shipping also is free, and takes only a few days. It is a bit more expensive than Empower, which was $96.00 for 12,000iu, but shipping with Empower was a minimum of $12.00 and could be slow at times. When you factor in Defy's prescription call-in fee, it gets more expensive, but Dr. Saya included one refill so I won't have to pay that call-in fee every time.

Breaking it down, including shipping, compounded HCG from Empower came out to about about $0.009/iu, while Pregnyl through Optum, including Defy's call-in fee (50% since you pay every other time), comes out to about $0.013/iu. Definitely more expensive, but not prohibitively so, and syringes are included with Optum.
I have United Healthcare Medicare Advantage PPO and Optum provides the mail order pharmacy service and mental health service. When my urologist was prescribing two vials of enanthate, every six weeks two more vials arrived. I ended up with a surplus for several months. LOL.
 

crazyhaha

Member
No just HCG. I honestly think it’s because I’m insured that I get such a hard time. They often try to quote me at $115 for the HCG and then I have to correct them. I think it’s because if they charge $115 they would still claim a reimbursement from OptimRx/UHC (my insurance).
These PBMs have such awful consumer practices. Congress is currently in the process of drafting a bill to curb their practices.
Does anyone have experience with CVS Specialty Pharmacy for HCG? A couple years ago I tried to get it filled under insurance and CVS specialty wouldn't even let me pay out of pocket and just flat out refused to send it because it wasn't covered.

I totally agree with the PBMs being awful. My current insurance PBM is CVS and I can get my prescriptions cheaper through Mark Cuban's Cost Plus place than CVS. I'm not even allowed to get Rx's covered if I go to a regular store...other than CVS.
 
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