Oh lord I can’t pay out of pocket for the shot. But the good news is it is not an infusion, but self-administered. I receive the shot from a refrigerated box via courier in monthly amounts (4 shots) and as of last year I am able to get pre-authorization from my insurance to get up to 10 weeks of the shot to get delivered to my house at once to take abroad. I spend a bunch of time calling insurance, getting my Rheumatologist to approve it when I’m going abroad and then can get a bigger supply brought by the courier. The actual shots are stable for like ~18 months in refrigeration so stockpiling is only an insurance issue.
The big issue with long-term travel is refrigeration. The shots must be refrigerated but as of 2016 is allowed via the FDA to be out of refrigeration for 14 days (within a small temperature range) BUT you can’t put it back in the fridge once you take it out. That means for ~3 week trips, I take a shot right before I leave, and bring two along with me out of refrigeration which lasts me 2 weeks as long as I’m not staying somewhere that’s like 100F.
For a month-long trip, I skip my last shot of the month (since it is an immunosuppressant, I have to skip it if I’m getting a cold anyway, so missing a week’s shot sucks a little but isn’t hugely problematic.) Two weeks of skipped shots does become an issue since, umm, I don’t take this medication just for funsies, so any trip over 5 weeks has a different strategy.
For longer trips, I have to make sure I have access to a refrigerator at my destination (sometimes choosing an airbnb or hostel over a regular hotel for that reason, but you can ask a traditional hotel to store them in the kitchen) and then I have a special carry-on refrigerated lunchbox style thing (given to me by the drug company) that I take on planes. I usually try to find a public bathroom with needle disposal boxes (all airports have them) to get rid of the needles, but sometimes I actually just carry them home :-P
Always happy to share my experience with the drug! I was so nervous to go on entercept due to the travel logistics (& cost) involved, but luckily it has mostly been great except for the $36,000 annual cost. And the drug is the only thing that has worked to treat my condition (RA) despite me trying literally every other commercially available drug for it before this.