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  • 1.  Cost of Bicillin without 340b

    Posted 06-29-2025 12:05
    Edited by Tagbo Ekwonu 06-29-2025 14:02

    The average cost of Bicillin LA 2.4 MU for treating Syphilis is $7000 for a box of 10. A box of 10 from Henry Schein, a medical supplier, costs $10,000. 

    I don't have 340 b, but I have a large HIV population and a high rate of Syphilis diagnosis. It seems the only option I have is to treat them all with Doxycycline or send them to the local health department. Medicaid, Medicare, and commercial insurance do not pay enough to cover the cost. I will appreciate any recommendations on getting Bicillin at a cheaper rate. 



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    Tagbo Ekwonu
    Charlotte NC
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  • 2.  RE: Cost of Bicillin without 340b

    Posted 06-29-2025 23:21

    There are some options listed here, in addition to a more detailed explanation of the current shortage: https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=909&loginreturnUrl=SSOCheckOnly. I think doxy treatment should be a last resort. 



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    Alex Gonzalez
    Natick MA
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  • 3.  RE: Cost of Bicillin without 340b

    Posted 06-30-2025 14:27

    Have you tried reaching out to your local Health Department to see if they have a Bicillin delivery program? I know in our County the Health Department will provide Bicillin to private clinics for administration to patients with syphilis, with the appropriate pile of paperwork, of course. 



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    Deb Fredell-Gonzalez PA-C, AAHIVS
    NIDO Clinic
    Salinas, CA
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  • 4.  RE: Cost of Bicillin without 340b

    Posted 07-02-2025 07:24

    I have contacted the Mecklenburg Health Department several times, but they have shown no interest in helping out.

    I will certainly look into the other options suggested by Alex. Thanks for your input. 



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    Tagbo Ekwonu
    Charlotte NC
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  • 5.  RE: Cost of Bicillin without 340b

    Posted 07-02-2025 22:09

    When I was in private practice in New York I had the same challenge. no way to recoup the cost of bicillin. I had to tell the patients to go to the local health department. I wonder how the health department and my current organization can get it and at what price. Yet another reason why I had to give up my private practice. 



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    Reynaldo Alonso
    West Hollywood CA
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  • 6.  RE: Cost of Bicillin without 340b

    Posted 07-03-2025 19:01

    I am encountering the same issues at my private practice clinic. I've reached out to the health dept as well but they cannot help me. I have no 340b and I am not planning to get one. I just treated a patient this week with Syphilis and prescribed Doxy. 

    My clinic cannot afford to buy this super expensive drug.

    If the pt prefers an injectable, I send them to the health dept for tx. 



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    William Amistad, Jr.
    Yuma AZ
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