Dear Dr. Bob,

Thanks for all your thoughts and good advice on New-Fill treatments. I had three treatments and have been satisfied. Still, I would like one more treatment, and my physician who administered it agrees. Unfortunately, the cost of New-Fill (Sculptra) is now $960 for one kit, double the cost from just two months ago. This does not include the cost of administering the product. Do you have any suggestions as to how we facially challenged folks can get the product any cheaper -- maybe from another country? It appears that the pharmaceutical company distributing it in the U.S. is sticking it to us. Also, do you think there is any chance that insurers, such as Kaiser, may come around to covering such a treatment? Thanks, Still Under Reconstruction

Hello Still Under Reconstruction,

I was more than shocked when I heard the price had skyrocketed to $960 per kit! That's almost four times what I paid per kit when I had my treatments several years ago. Aventis, the company marketing New-Fill under the name Sculptra, is indeed "sticking it to us" and not in a good way! I believe this type of price gouging is unconscionable.

As for insurance coverage, there is no doubt in my mind that treatment of lipoatrophy is "reconstructive" and not cosmetic. It meets all the criteria for a reconstructive procedure. The plastic surgeons whom I have spoken to have begun using diagnostic and treatment codes that reflect a reconstructive, rather than cosmetic, procedure. Next, we have to convince the various insurers that these codes are indeed accurate and correct. Stay tuned; I'll keep you posted as this story unfolds.

By the way, even though we'll bill your insurance as if you are "still under reconstruction," I prefer to think of you as "a work in progress,"

Dr. Bob